Individual
TIMOTHY O'HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1344 S APOLLO BLVD, STE 301, MELBOURNE, FL 32901-3183
(321) 676-2353
(321) 951-9267
Mailing address
1344 S APOLLO BLVD, STE 301, MELBOURNE, FL 32901-3183
(321) 676-2353
(321) 951-9267
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME84166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040017000
RAILROAD MEDICARE
FL
01
—
1356109001
CIGNA
FL
01
—
15346
BLUE CROSS BLUE SHIELD
FL
01
—
198914
WELLCARE
FL
05
—
263645000
—
FL
01
—
2862947
AETNA
FL
01
—
7795340
AETNA
FL
Enumeration date
12/16/2005
Last updated
05/27/2008
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