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General NPI Number Information
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NPI Number | 1033129804
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Entity Type | Individual
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Provider Name | GERALD LEE TODOROFF PSYD
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 5327 COMMERCIAL WAY C 115
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City | SPRING HILL
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State | FL
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Zip | 34606-1448
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Country | US
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Telephone | 352-597-5497
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Fax | 352-597-1662
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Provider Business Mailing Address
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Address Line | 5327 COMMERCIAL WAY C 115
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City | SPRING HILL
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State | FL
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Zip | 34606-1448
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Country | US
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Telephone | 352-597-5497
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Fax | 352-597-1662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | MD3030
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY5565
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License Number State | FL
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