Provider Demographics
NPI:1528059946
Name:BEHRMANN, TODD STUART (DPM)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:STUART
Last Name:BEHRMANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 E TARPON AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689
Mailing Address - Country:US
Mailing Address - Phone:727-944-2522
Mailing Address - Fax:727-944-2524
Practice Address - Street 1:651 E TARPON AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689
Practice Address - Country:US
Practice Address - Phone:727-944-2522
Practice Address - Fax:727-944-2524
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00002519213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390373700Medicaid
FL65439OtherBC
FL390373700Medicaid
FLK1101Medicare PIN
FL65439OtherBC
FL4355000001Medicare NSC