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General NPI Number Information
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NPI Number | 1952709065
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Entity Type | Individual
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Provider Name | TIMOTHY S MINGEE PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 26800 S TAMIAMI TRL STE 340
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4355
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Country | US
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Telephone | 239-495-4490
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Fax | 239-495-4491
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-495-4490
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Fax | 239-495-4491
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9108283
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License Number State | FL
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