Provider Demographics
NPI:1104671221
Name:TOLEDO MENDEZ, MAYLEN
Entity type:Individual
Prefix:
First Name:MAYLEN
Middle Name:
Last Name:TOLEDO MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15450 SW 77TH CIRCLE LN APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1872
Mailing Address - Country:US
Mailing Address - Phone:786-241-4959
Mailing Address - Fax:
Practice Address - Street 1:15450 SW 77TH CIRCLE LN APT 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1872
Practice Address - Country:US
Practice Address - Phone:786-241-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator