Basic Information
| Provider Information | |||||||||
| NPI: | 1114060035 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOLEDO | ||||||||
| FirstName: | SUSSETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9220 FONTAINEBLEAU BLVD APT 209 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331724237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052258002 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4175 W 20TH AVE | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330125874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058250300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH6173 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.