Provider Demographics
NPI:1689672602
Name:PERSONAL FAMILY HEALTH CARE
Entity type:Organization
Organization Name:PERSONAL FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:
Authorized Official - Last Name:TORO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-369-2226
Mailing Address - Street 1:391 LEE BLVD
Mailing Address - Street 2:400
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4973
Mailing Address - Country:US
Mailing Address - Phone:239-369-2226
Mailing Address - Fax:239-369-5820
Practice Address - Street 1:391 LEE BLVD
Practice Address - Street 2:400
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4973
Practice Address - Country:US
Practice Address - Phone:239-369-2226
Practice Address - Fax:239-369-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2010-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266565400Medicaid
FL266565400Medicaid
FL=========OtherTAX ID
FLK4360Medicare ID - Type Unspecified