Individual
DR. TIMOTHY D ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
345 N CLYDE MORRIS BLVD, SUITE 330, ORMOND BEACH, FL 32174-3114
(386) 672-4244
Mailing address
345 N CLYDE MORRIS BLVD, SUITE 330, ORMOND BEACH, FL 32174-3114
(386) 672-4244
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
000487
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000475900
—
FL
Enumeration date
05/07/2007
Last updated
06/07/2012
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