Provider Demographics
NPI:1821140161
Name:HOWARD, TOD ANDRE (DC)
Entity Type:Individual
Prefix:DR
First Name:TOD
Middle Name:ANDRE
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 BOWMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3406
Mailing Address - Country:US
Mailing Address - Phone:352-429-9571
Mailing Address - Fax:
Practice Address - Street 1:237 W BROAD ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-2511
Practice Address - Country:US
Practice Address - Phone:352-429-9571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL558008OtherBLUE CROSS BLUE SHIELD
FLE1729Medicare ID - Type Unspecified
FL558008OtherBLUE CROSS BLUE SHIELD