Basic Information
| Provider Information | |||||||||
| NPI: | 1548765357 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TIMMEL | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | ARLINGTON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3013 W HAWTHORNE RD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336112831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132949815 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7050 GALL BLVD | ||||||||
| Address2: | |||||||||
| City: | ZEPHYRHILLS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335411347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137880411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2018 | ||||||||
| LastUpdateDate: | 08/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 11420237-1205 | UT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.