MEDICARE: DR. MICHAEL R TODD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	R3610	TX
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	45727	CO
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	036111736	IL

General Provider Information

NPI Number	:	1437117637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL R TODD M.D.

Provider Business Mailing Address
First Line	:	4700 MILLENIA BLVD STE 650
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-6013
Country	:	US
Telephone Number	:	407-533-6836
Fax Number	:	407-232-9316

Provider Business Practice Location Address
First Line	:	9108 CAMP BOWIE WEST BLVD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76116-6098
Country	:	US
Telephone Number	:	682-990-6492
Fax Number	:	877-688-9560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/30/2026

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