Healthcare Provider Details

I. General information

NPI: 1639151434
Provider Name (Legal Business Name): MARILYN TOLEDO GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SARGENTO HERNANDEZ URB ATENAS J-7
MANATI PR
00674
US

IV. Provider business mailing address

HC 6 BOX 10185
HATILLO PR
00659-9518
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-2558
  • Fax: 787-621-7889
Mailing address:
  • Phone: 787-884-2558
  • Fax: 787-884-5371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11802
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: