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General NPI Number Information
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NPI Number | 1144399932
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Entity Type | Organization
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Legal Business Name | ENDOCRINE SPECIALIST PA
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 730 GOODLETTE ROAD NORTH SUITE 205
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City | NAPLES
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State | FL
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Zip | 34102-5618
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Country | US
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Telephone | 239-436-3666
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Fax | 239-436-3678
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Provider Business Mailing Address
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Address Line | 730 GOODLETTE ROAD NORTH SUITE 205
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City | NAPLES
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State | FL
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Zip | 34102-5618
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Country | US
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Telephone | 239-436-3666
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Fax | 239-436-3678
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TODD D BRODIE
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Credential | M.D.
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Telephone | 239-436-3666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME73670
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License Number State | FL
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