MEDICARE: TIMESHA WHITE

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	225700000X	Massage Therapist	107887	FL

General Provider Information

NPI Number	:	1639022791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMESHA WHITE

Provider Business Mailing Address
First Line	:	10622 RUTGERS RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-5269
Country	:	US
Telephone Number	:	561-951-0914
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 BALMORAL CIR N STE 305
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-5583
Country	:	US
Telephone Number	:	561-951-0914
Fax Number	:

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

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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Directions to “ TIMESHA WHITE ” Practice Location

Language	Start Address	Practice Location

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