Blain, Timothy

Blain, Timothy is an individual health care provider with primary practice located at 779 Medical Dr Ste 2 , Englewood FL 34223-3980. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Blain, Timothy can be contacted via phone (941) 698-6363.

Contact Information

Primary practice address
779 Medical Dr Ste 2 Englewood FL 34223-3980
Phone: (941) 698-6363
Fax: (941) 800-5848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME107462 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME107462 Florida

Profile Details

NPI number 1558451849
LBN Legal business name Blain, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2006
Last updated Jul 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558451849 NPPES
Florida Other P00865254 RAILROAD MEDICARE
Florida MEDICAID 003184600 RAILROAD MEDICARE

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