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NPI Code Detail

MEDICARE: TIMOTHY PHILEMON HERRING

MEDICARE: TIMOTHY PHILEMON HERRING
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1104672203
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY PHILEMON HERRING
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2331 HANSEN CT
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32301-4859
Country : US
Telephone Number : 850-320-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2024
Last Update Date : 06/07/2026

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Directions to “ TIMOTHY PHILEMON HERRING ” Practice Location

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