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NPI Code Detail

MEDICARE: PAUL RICHARD TIMLER JR. P.T.

MEDICARE: PAUL RICHARD TIMLER JR. P.T.
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
1225100000XPhysical TherapistPT22433FL

General Provider Information

NPI Number : 1376621409
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL RICHARD TIMLER JR. P.T.
Provider Business Mailing Address
First Line : 1505 FORT CLARKE BLVD
Second Line : 9106
City : GAINESVILLE
State : FL
Zip : 32606-7182
Country : US
Telephone Number : 941-524-8380
Fax Number :
Provider Business Practice Location Address
First Line : 4820 W NEWBERRY RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32607-2249
Country : US
Telephone Number : 352-692-2131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/08/2007

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