Healthcare Provider Details

I. General information

NPI: 1487350179
Provider Name (Legal Business Name): LUIS TOLEDO-ESPIETT, OD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 07/02/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11160 VEIRS MILL RD SPC G1
SILVER SPRING MD
20902-2542
US

IV. Provider business mailing address

1900 CHAPMAN AVE APT 416
ROCKVILLE MD
20852-1986
US

V. Phone/Fax

Practice location:
  • Phone: 443-970-9044
  • Fax:
Mailing address:
  • Phone: 443-970-9044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. LUIS TOLEDO
Title or Position: CEO
Credential: OD
Phone: 443-970-9044