Healthcare Provider Details

I. General information

NPI: 1225102577
Provider Name (Legal Business Name): TIMOTHY M CYMANSKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 49TH ST N STE C
ST PETERSBURG FL
33710-5237
US

IV. Provider business mailing address

2150 49TH ST N STE C
ST PETERSBURG FL
33710-5237
US

V. Phone/Fax

Practice location:
  • Phone: 727-327-0721
  • Fax: 727-327-2875
Mailing address:
  • Phone: 727-327-0721
  • Fax: 727-327-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11014
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number5792
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: