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NPI Code Detail

MEDICARE: DR. TIMOTHY HARBUCK O.D.

MEDICARE: DR. TIMOTHY HARBUCK O.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
1152W00000XOptometristOPC5372FL

General Provider Information

NPI Number : 1538696109
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY HARBUCK O.D.
Provider Business Mailing Address
First Line : 1521 W GRANADA BLVD
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5920
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1521 W GRANADA BLVD
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5920
Country : US
Telephone Number : 386-672-6134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2017
Last Update Date : 05/15/2017

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Directions to “ DR. TIMOTHY HARBUCK O.D.” Practice Location

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