Healthcare Provider Details

I. General information

NPI: 1598276420
Provider Name (Legal Business Name): CARLA D TOTH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 WINYAH DR
ORLANDO FL
32803-1226
US

IV. Provider business mailing address

907 W 20TH ST
SANFORD FL
32771-3329
US

V. Phone/Fax

Practice location:
  • Phone: 407-733-0818
  • Fax: 407-733-0818
Mailing address:
  • Phone: 304-617-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number9345038
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: