MEDICARE: TIMOTHY H TWEITO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	13099	NV
2	207W00000X	Ophthalmology Physician	MD00046436	WA
3	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME149069	FL

General Provider Information

NPI Number	:	1023066578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY H TWEITO M.D.

Provider Business Mailing Address
First Line	:	280 N SYKES CREEK PKWY STE B
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3491
Country	:	US
Telephone Number	:	321-735-8800
Fax Number	:	321-735-8898

Provider Business Practice Location Address
First Line	:	280 N SYKES CREEK PKWY STE B
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3491
Country	:	US
Telephone Number	:	321-735-8800
Fax Number	:	321-735-8898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	11/08/2022

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