1558358630 NPI number — EDIT TOLNAI M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558358630 NPI number — EDIT TOLNAI M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

TOLNAI

Provider First Name:

EDIT

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1558358630

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/30/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2234 COLONIAL BLVD

Provider Second Line Business Mailing Address:

ATTN: PAYER CONTRACTING & RELATIONS DEPT.

Provider Business Mailing Address City Name:

FORT MYERS

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

33907-1412

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

239-931-7342

Provider Business Mailing Address Fax Number:

239-931-7385

Provider First Line Business Practice Location Address:

431 UNIVERSITY BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

JUPITER

Provider Business Practice Location Address State Name:

FL

Provider Business Practice Location Address Postal Code:

33458-3103

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

561-296-9147

Provider Business Practice Location Address Fax Number:

561-296-9148

Provider Enumeration Date:

10/04/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RH0000X , with the licence number:  ME88991 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RH0003X , with the licence number: ME88991 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RX0202X , with the licence number: ME88991 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 119926200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 302686 . This is a "WELLCARE MEDICARE LOB" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 10924 . This is a "DIMENSION HEALTH PPO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: P971440 . This is a "OPTIMUM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: RV635 . This is a "MEDICARE HF" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 01327 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: P01582236 . This is a "RR MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 297761 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: P1035645 . This is a "FREEDOM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 7553627 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".