Healthcare Provider Details

I. General information

NPI: 1962039404
Provider Name (Legal Business Name): ALEXANDRIA TIMMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 PRUDENTIAL DR STE 1900
JACKSONVILLE FL
32207-8373
US

IV. Provider business mailing address

PO BOX 44008
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-633-0920
  • Fax: 904-633-0921
Mailing address:
  • Phone: 904-383-1015
  • Fax: 904-244-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number160755
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: