# TOLES PROVIDER SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184385874
- **Authorized official:** JERJUAN TOLES (OWNER)
- **Authorized official phone:** (239) 595-9040

## Contact information

- **Practice address:** 5319 19TH AVE SW, NAPLES, FL 34116-5631
- **Practice address phone:** (239) 595-9040
- **Practice address fax:** (239) 330-7028
- **Mailing address:** 5319 19TH AVE SW, NAPLES, FL 34116-5631
- **Mailing address phone:** (239) 595-9040
- **Mailing address fax:** (239) 330-7028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 171W00000X | Contractor | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | — | — |

## Other

- **Enumeration date:** 01/04/2022
- **Last updated:** 03/15/2022