Healthcare Provider Details

I. General information

NPI: 1063435758
Provider Name (Legal Business Name): TIMOTHY J WHYATT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 SW 34TH CIR. STE 102
OCALA FL
34474-6619
US

IV. Provider business mailing address

3301 SW 34TH CIR. STE 102
OCALA FL
34474-6619
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-0444
  • Fax: 352-861-0464
Mailing address:
  • Phone: 352-861-0444
  • Fax: 352-861-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO2753
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO 2753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: