Individual
MR. TODD DAVID IKENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 398-6661
Mailing address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 398-6661
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
011911
NY
363AS0400X
Surgical Physician Assistant
Primary
PA9105419
FL
Other
Enumeration date
05/16/2008
Last updated
03/29/2013
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