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NPI Code Detail

MEDICARE: ELSA K TOLEDO PORTUONDO

MEDICARE: ELSA K TOLEDO PORTUONDO
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
1106S00000XBehavior TechnicianRBT-25-439342FL

General Provider Information

NPI Number : 1578457784
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELSA K TOLEDO PORTUONDO
Provider Business Mailing Address
First Line : 525 NW 27TH AVE STE 100
Second Line :
City : MIAMI
State : FL
Zip : 33125-3039
Country : US
Telephone Number : 305-200-5073
Fax Number :
Provider Business Practice Location Address
First Line : 525 NW 27TH AVE STE 100
Second Line :
City : MIAMI
State : FL
Zip : 33125-3039
Country : US
Telephone Number : 305-200-5073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 03/25/2026

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Directions to “ ELSA K TOLEDO PORTUONDO ” Practice Location

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