Organization
TIMOTHY C. RUNYON, DPM, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE J KINMON (CEO)
(561) 995-0229
Entity
Organization
Contact information
Practice address
2540 WINKLER AVE, FORT MYERS, FL 33901-9338
(239) 278-4100
Mailing address
1401 16TH ST N, ST PETERSBURG, FL 33704-4123
(727) 894-0794
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
10/09/2024
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