Healthcare Provider Details

I. General information

NPI: 1649250614
Provider Name (Legal Business Name): TODD IRWIN PARNES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13660 JOG RD SUITE 3
DELRAY BEACH FL
33446-3806
US

IV. Provider business mailing address

13660 JOG RD SUITE 3
DELRAY BEACH FL
33446
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-2002
  • Fax: 561-733-3742
Mailing address:
  • Phone: 561-495-2002
  • Fax: 561-733-3742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberOS8153
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberOS8153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: