Provider Demographics
NPI:1457450173
Name:TOSHNIWAL, LATA (MD)
Entity type:Individual
Prefix:DR
First Name:LATA
Middle Name:
Last Name:TOSHNIWAL
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 1:1226 LAKE WHITNEY DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6070
Mailing Address - Country:US
Mailing Address - Phone:407-970-3069
Mailing Address - Fax:407-258-8279
Practice Address - Street 1:ADVENT HEALTH
Practice Address - Street 2:601 E ROLLINS STREET
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4639
Practice Address - Country:US
Practice Address - Phone:407-970-3069
Practice Address - Fax:407-258-8279
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00580382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252359100Medicaid
F72871Medicare UPIN
23686Medicare ID - Type Unspecified