MEDICARE: BRUCE I TIMINS MD PA

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	207RC0000X	Cardiovascular Disease Physician	ME 36915	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194993659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE I TIMINS MD PA

Provider Business Mailing Address
First Line	:	PO BOX 1976
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33970-1976
Country	:	US
Telephone Number	:	239-303-2640
Fax Number	:	239-303-2981

Provider Business Practice Location Address
First Line	:	1154 LEE BLVD
Second Line	:	UNIT 2
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-4852
Country	:	US
Telephone Number	:	239-303-2640
Fax Number	:

Authorized Official
Title or Position	:	AR SPECIALIST
Name	:	KIM FRAZIER
Credential	:	CPC
Telephone Number	:	727-848-3761

Provider Enumeration Date	:	02/18/2008
Last Update Date	:	03/15/2010

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Directions to “BRUCE I TIMINS MD PA ” Practice Location

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