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General NPI Number Information
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NPI Number | 1033567839
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Entity Type | Individual
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Provider Name | TIMOTHY ZACK DAY PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 603 7TH ST S STE 500
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4734
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Country | US
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Telephone | 727-893-6435
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Fax | 727-893-6436
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Provider Business Mailing Address
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Address Line | 603 7TH ST S STE 500
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4734
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Country | US
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Telephone | 727-893-6254
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Fax | 727-553-7158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA058160
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9113305
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License Number State | FL
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