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General NPI Number Information
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NPI Number | 1962587196
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Entity Type | Organization
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Legal Business Name | TIMOTHY FOSTER PH D LLC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 30 N RING AVE #200
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-4224
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Country | US
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Telephone | 813-784-0247
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Fax |
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Provider Business Mailing Address
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Address Line | 30 N RING AVE #200
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-4224
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Country | US
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Telephone | 813-784-0247
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY FOSTER
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Credential | PHD.
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Telephone | 813-385-3794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PY2203
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License Number State | FL
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