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General NPI Number Information
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NPI Number | 1740634930
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Entity Type | Organization
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Legal Business Name | THE TOLEDO CLINIC, LLC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 5481 NW EAST TORINO PARKWAY
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City | PORT ST. LUCIE
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State | FL
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Zip | 34986
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Country | US
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Telephone | 772-281-2626
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Fax | 772-905-8241
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Provider Business Mailing Address
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Address Line | 5481 NW EAST TORINO PKWY
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-4600
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Country | US
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Telephone | 772-281-2626
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Fax | 646-661-0932
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSE R TOLEDO
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Credential | M.D.
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Telephone | 772-281-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | ME60437
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | FL
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