Provider Demographics
NPI:1427331446
Name:MURPHY, TODD
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 A1A S
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6933
Mailing Address - Country:US
Mailing Address - Phone:904-471-9026
Mailing Address - Fax:904-471-9130
Practice Address - Street 1:3975 A1A S
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6933
Practice Address - Country:US
Practice Address - Phone:904-471-9026
Practice Address - Fax:904-471-9130
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist