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General NPI Number Information
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NPI Number | 1558969139
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Entity Type | Organization
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Legal Business Name | SW FLORIDA MEDICAL GROUP LLC
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 3637 DEL PRADO BLVD S STE 101
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City | CAPE CORAL
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State | FL
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Zip | 33904-7199
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Country | US
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Telephone | 239-269-8767
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 DEL PRADO BLVD S STE 101
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City | CAPE CORAL
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State | FL
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Zip | 33904-7199
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Country | US
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Telephone | 239-269-8767
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOMAS TOLEDO
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Credential |
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Telephone | 239-269-8767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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