Wilson, Timothy R

Wilson, Timothy R is an individual health care provider with primary practice located at 300 71St Street Suite 620, Miami Beach FL 33141-3089. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Timothy R can be contacted via phone (305) 866-9951.

Contact Information

Primary practice address
300 71St Street Suite 620 Miami Beach FL 33141-3089
Phone: (305) 866-9951
Fax: (877) 284-8933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101238898 Virginia

Profile Details

NPI number 1487613402
LBN Legal business name Wilson, Timothy R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Nov 1st, 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 1487613402 NPPES
Other C05516 MEDICARE GROUP NUMBER
MEDICAID 010199824 MEDICARE GROUP NUMBER

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