Organization
TIMOTHY CHAN DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY CHAN DPM (OWNER)
(863) 273-8190
Entity
Organization
Contact information
Practice address
11375 CORTEZ BLVD, WEEKI WACHEE, FL 34613-5409
(352) 596-6632
Mailing address
12180 28TH ST N, ST PETERSBURG, FL 33716-1820
(727) 572-5449
(727) 573-2048
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3400
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
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Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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