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General NPI Number Information
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NPI Number | 1730298837
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Entity Type | Individual
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Provider Name | TIMOTHY JOSEPH JENKINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 52 W UNDERWOOD ST MP # 153 ATTN LESLIE FRAZIER
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City | ORLANDO
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State | FL
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Zip | 32806
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Country | US
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Telephone | 321-842-8475
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Fax | 407-849-6470
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Provider Business Mailing Address
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Address Line | 52 W UNDERWOOD ST MP # 153 ATTN LESLIE FRAZIER
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City | ORLANDO
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State | FL
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Zip | 32806
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Country | US
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Telephone | 321-842-8475
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Fax | 407-849-6470
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME147057
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License Number State | FL
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