MEDICARE: TIMOTHY M CYMANSKI DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	11014	FL
2	111NX0800X	Orthopedic Chiropractor	5792	CO
3	111N00000X	Chiropractor	CH11014	FL

General Provider Information

NPI Number	:	1225102577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY M CYMANSKI DC

Provider Business Mailing Address
First Line	:	2150 49TH ST N STE C
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5237
Country	:	US
Telephone Number	:	727-327-0721
Fax Number	:	727-327-2875

Provider Business Practice Location Address
First Line	:	2150 49TH ST N STE C
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5237
Country	:	US
Telephone Number	:	727-327-0721
Fax Number	:	727-327-2875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	08/25/2021

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