Healthcare Provider Details
I. General information
NPI: 1083885875
Provider Name (Legal Business Name): KAMILL R DEL TORO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/19/2008
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1315 JEFFERSON HWY
NEW ORLEANS LA
70121-2406
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-842-5200
- Fax: 504-842-5647
- Phone: 504-842-4000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 200694 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | MD.200694 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: