Provider Demographics
NPI:1598449639
Name:FIXLER, TODD WILLIAM
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:WILLIAM
Last Name:FIXLER
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 1:3730 DARTMOUTH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7546
Mailing Address - Country:US
Mailing Address - Phone:727-418-4000
Mailing Address - Fax:
Practice Address - Street 1:4710 N HABANA AVE STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7146
Practice Address - Country:US
Practice Address - Phone:813-450-3457
Practice Address - Fax:877-235-3648
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1021106363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner