Provider Demographics
NPI:1215920160
Name:TRAUB, TODD STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:STEVEN
Last Name:TRAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 510
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6602
Mailing Address - Country:US
Mailing Address - Phone:813-872-4492
Mailing Address - Fax:813-830-9400
Practice Address - Street 1:1717 E MORTEN AVE UNIT 26
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4755
Practice Address - Country:US
Practice Address - Phone:727-743-0680
Practice Address - Fax:727-205-5430
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46617207L00000X
FLME53592207L00000X, 208VP0000X, 208VP0014X
MEMD25704207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00054081OtherRAILROAD MEDICARE
FL08391OtherBLUE CROSS
FL08391SMedicare PIN
FL08391OtherBLUE CROSS