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
2919 W SWANN AVE STE 203, TAMPA, FL 33609-4050
(813) 875-0555
(866) 313-3106
Mailing address
2919 W SWANN AVE STE 203, TAMPA, FL 33609-4050
(813) 875-0555
(866) 313-3106
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004C8
BCBS GROUP NUMBER
FL
01
—
008390800
MEDICAID GROUP NUMBER
FL
01
—
M2475
MEDICARE GROUP PTAN
FL
Enumeration date
01/18/2007
Last updated
12/13/2023
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