Healthcare Provider Details

I. General information

NPI: 1396745410
Provider Name (Legal Business Name): ANTHONY JAY RAIMONDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 CHERRY ST STE ACC 200
TOLEDO OH
43608-2603
US

IV. Provider business mailing address

2213 CHERRY ST STE ACC 200
TOLEDO OH
43608-2603
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-4283
  • Fax: 419-251-0814
Mailing address:
  • Phone: 419-251-4283
  • Fax: 419-251-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35-058176
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number35.058176
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: