Healthcare Provider Details

I. General information

NPI: 1164627592
Provider Name (Legal Business Name): ANDRES DARIO TORO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2007
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE C-301
MIAMI FL
33136-1005
US

IV. Provider business mailing address

10441 SW 66TH TER
MIAMI FL
33173-1312
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6970
  • Fax: 305-545-6501
Mailing address:
  • Phone: 786-493-2837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME104505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: