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Organization

ADVANCED PODIATRY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TODD JAMES BRENNAN DPM (PRESIDENT)
(813) 971-4678
Entity
Organization

Contact information

Practice address
17222 HOSPITAL BLVD, SUITE 218, BROOKSVILLE, FL 34601-8925
(352) 796-7800
(352) 796-1203
Mailing address
13801 BRUCE B DOWNS BLVD STE 205, TAMPA, FL 33613-3937
(813) 971-4678
(813) 482-0036

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
PO2520
FL
213ES0131X
Foot Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1982756706
GROUP NPI
FL
01
M2469
MEDICARE GROUP PTAN
FL
01
M2475
MEDICARE GROUP PTAN
FL
Enumeration date
06/05/2008
Last updated
09/30/2020
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