Childers, Timothy Charles

Childers, Timothy Charles is an individual health care provider with primary practice located at 1181 Orange Ave , Winter Park FL 32789-4907. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Childers, Timothy Charles can be contacted via phone (407) 647-1331.

Contact Information

Primary practice address
1181 Orange Ave Winter Park FL 32789-4907
Phone: (407) 647-1331
Fax: (407) 571-2757
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 73071 Florida

Profile Details

NPI number 1982609921
LBN Legal business name Childers, Timothy Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jan 4th, 2010 - about 14 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 1982609921 NPPES
Florida MEDICAID 258553700
Florida Other 020050628

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