Individual
EDWARD ROBERT TODD
Active
Individual
EDWARD ROBERT TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290164100
—
FL
01
—
E0967S
QSS SCS PTAN
FL
Enumeration date
04/14/2006
Last updated
03/17/2018
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