Provider Demographics
NPI:1447826672
Name:TOLEDO, ANGELA MARY (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:TOLEDO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARY
Other - Last Name:BACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4911 CULDESAC CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7757
Mailing Address - Country:US
Mailing Address - Phone:407-868-6382
Mailing Address - Fax:
Practice Address - Street 1:4911 CULDESAC CT
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7757
Practice Address - Country:US
Practice Address - Phone:407-868-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010798363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care