Healthcare Provider Details

I. General information

NPI: 1497022875
Provider Name (Legal Business Name): GERALD L TODOROFF, PSYD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

IV. Provider business mailing address

5465 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-5497
  • Fax:
Mailing address:
  • Phone: 352-597-5497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. GERALD L TODOROFF
Title or Position: OWNER
Credential: PSYD
Phone: 352-597-5497