Healthcare Provider Details

I. General information

NPI: 1932674033
Provider Name (Legal Business Name): TORODENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 WEBB RD STE D1
TAMPA FL
33615-3255
US

IV. Provider business mailing address

5420 WEBB RD STE D1
TAMPA FL
33615-3255
US

V. Phone/Fax

Practice location:
  • Phone: 813-886-0545
  • Fax: 813-514-4869
Mailing address:
  • Phone: 813-886-0545
  • Fax: 813-514-4869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. EDGARDO J TORO-QUINONES
Title or Position: MANAGER
Credential: DMD
Phone: 787-605-9013