MEDICARE: MARY BRATOVICH TOTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	35-062468	OH
2	2080P0216X	Pediatric Rheumatology Physician	ME132977	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568454924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BRATOVICH TOTH M.D.

Provider Business Mailing Address
First Line	:	10140 CENTURION PKWY N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-4127
Fax Number	:	904-697-5102

Provider Business Practice Location Address
First Line	:	13535 NEMOURS PKWY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7402
Country	:	US
Telephone Number	:	407-567-4000
Fax Number	:	407-567-5924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2005
Last Update Date	:	10/13/2017

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