Healthcare Provider Details

I. General information

NPI: 1871707562
Provider Name (Legal Business Name): MARIBEL TOLEDO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 167 KM. 14.8
BAYAMON PR
00957
US

IV. Provider business mailing address

500 LAS VILLAS DE CIUDAD JARDIN APT. 402
BAYAMON PR
00957
US

V. Phone/Fax

Practice location:
  • Phone: 787-799-9977
  • Fax: 787-799-9977
Mailing address:
  • Phone: 787-485-0734
  • Fax: 787-799-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12436
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: