=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255882593
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SILVANA TOSCANO PA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2016
-----------------------------------------------------
Last Update Date | 04/20/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11181 HEALTH PARK BLVD STE 3030
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110-5738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-856-3774
-----------------------------------------------------
Fax | 239-599-2612
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9410 FOUNTAIN MEDICAL CT STE 200
-----------------------------------------------------
City | BONITA SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34135-4525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-948-4325
-----------------------------------------------------
Fax | 239-288-0574
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA9109749
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------