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General NPI Number Information
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NPI Number | 1306012232
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Entity Type | Individual
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Provider Name | TIMOTHY JOSEPH O'SHAUGHNESSY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1350 13TH AVE S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3203
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Country | US
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Telephone | 904-627-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 44 BUCKTAIL AVE
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City | PONTE VEDRA
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State | FL
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Zip | 32081-6181
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 73989
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 73989
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME114323
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | ME114323
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License Number State | FL
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