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General NPI Number Information
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NPI Number | 1760629406
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Entity Type | Organization
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Legal Business Name | TIMOTHY A REDMAN PH D LLC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 3344 BAHIA VISTA ST
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City | SARASOTA
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State | FL
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Zip | 34239-7386
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Country | US
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Telephone | 941-951-0343
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Fax | 866-601-3427
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Provider Business Mailing Address
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Address Line | 3344 BAHIA VISTA ST
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City | SARASOTA
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State | FL
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Zip | 34239-7386
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Country | US
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Telephone | 941-951-0343
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Fax | 866-601-3427
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Authorized Official
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Title or Position | SINGLE SOLE MEMBER
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Name | DR. TIMOTHY A REDMAN
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Credential | PH. D
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Telephone | 941-951-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY3846
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License Number State | FL
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