Tivnan, John
Tivnan, John is an individual health care provider with primary practice located at 407 Avenue K Se , Winter Haven FL 33880-4126. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Tivnan, John can be contacted via phone (863) 294-3504.Contact Information
Primary practice address
407 Avenue K Se
Winter Haven FL 33880-4126
Phone: (863) 294-3504
Fax: (863) 299-0096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC 1060 | Florida |
Profile Details
| NPI number | 1013911379 |
|---|---|
| LBN Legal business name | Tivnan, John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013911379 | NPPES |
| Florida | MEDICAID | 078082100 |
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