Healthcare Provider Details

I. General information

NPI: 1790866242
Provider Name (Legal Business Name): TIMOTHY J CAHILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4402
US

IV. Provider business mailing address

8761 PERIMETER PARK BLVD SUITE 106
JACKSONVILLE FL
32216-1106
US

V. Phone/Fax

Practice location:
  • Phone: 904-641-6628
  • Fax: 904-642-1243
Mailing address:
  • Phone: 904-641-6628
  • Fax: 904-642-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number200400825
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME97443
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberS8965
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: