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General NPI Number Information
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NPI Number | 1295768398
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Entity Type | Organization
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Legal Business Name | DEARDOURFF TIMMONS & ASSOCIATES PA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 6420 NW 9TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4203
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Country | US
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Telephone | 352-331-2332
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Fax | 352-331-6515
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Provider Business Mailing Address
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Address Line | 6420 NW 9TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4203
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Country | US
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Telephone | 352-331-2332
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Fax | 352-331-6515
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Authorized Official
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Title or Position | SECRETARY
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Name | CHRISTOPHER M CASSISI
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Credential | MD
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Telephone | 352-331-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME79809
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License Number State | FL
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