Provider Demographics
NPI:1316431315
Name:MONTALVO-TOLEDO, LORENA ALEXANDRA (MD)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:ALEXANDRA
Last Name:MONTALVO-TOLEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140819
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0819
Mailing Address - Country:US
Mailing Address - Phone:787-420-0221
Mailing Address - Fax:
Practice Address - Street 1:404 AVE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4358
Practice Address - Country:US
Practice Address - Phone:787-878-2758
Practice Address - Fax:787-817-3531
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315316363AM0700X, 207W00000X
PR21521207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical