Provider Demographics
NPI:1588087787
Name:PORRAS TOLEDO, ALVARO (LAC, AP)
Entity type:Individual
Prefix:
First Name:ALVARO
Middle Name:
Last Name:PORRAS TOLEDO
Suffix:
Gender:M
Credentials:LAC, AP
Other - Prefix:
Other - First Name:ALVARO
Other - Middle Name:
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, AP
Mailing Address - Street 1:3825 SW 100TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9041
Mailing Address - Country:US
Mailing Address - Phone:352-672-1181
Mailing Address - Fax:352-559-2363
Practice Address - Street 1:4040 NEWBERRY RD STE 1500
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2393
Practice Address - Country:US
Practice Address - Phone:352-672-1181
Practice Address - Fax:352-559-2363
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist