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General NPI Number Information
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NPI Number | 1164744488
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Entity Type | Organization
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Legal Business Name | TIMOTHY L SCHNEIDER, MD PA
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 1909 BEACH BLVD SUITE 101
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-8608
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Country | US
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Telephone | 904-247-5575
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Fax | 904-247-3375
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Provider Business Mailing Address
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Address Line | 1909 BEACH BLVD SUITE 101
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-8608
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Country | US
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Telephone | 904-247-5575
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Fax | 904-247-3375
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY LUKE SCHNEIDER
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Credential | M.D.
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Telephone | 904-247-5575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME 68823
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License Number State | FL
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