Provider Demographics
NPI:1831393644
Name:ENDICOTT, TODD JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:JOHN
Last Name:ENDICOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4313 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4777
Mailing Address - Country:US
Mailing Address - Phone:352-373-4300
Mailing Address - Fax:352-373-4572
Practice Address - Street 1:4313 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-373-4300
Practice Address - Fax:352-373-4572
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A 10704207W00000X
FLOS15829207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LREH9OtherFLORIDA BLUE