Provider Demographics
NPI:1528955945
Name:TOLEDO, OTILIO D JR (APRN)
Entity type:Individual
Prefix:
First Name:OTILIO
Middle Name:D
Last Name:TOLEDO
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16915 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-8062
Mailing Address - Country:US
Mailing Address - Phone:352-409-8969
Mailing Address - Fax:
Practice Address - Street 1:16915 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-8062
Practice Address - Country:US
Practice Address - Phone:352-409-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program