Healthcare Provider Details

I. General information

NPI: 1093745838
Provider Name (Legal Business Name): HALEY TODSEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY PARKER-WINTER DO

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

IV. Provider business mailing address

PO BOX 850001
ORLANDO FL
32885-0299
US

V. Phone/Fax

Practice location:
  • Phone: 727-298-6612
  • Fax:
Mailing address:
  • Phone: 904-482-1070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS9804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: