Individual
TIMOTHY D CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR STE 2G, MELBOURNE, FL 32901-2607
(321) 725-4500
(321) 725-7028
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 473-4690
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME90660
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270323800
—
FL
01
—
46688Y
MEDICARE
FL
Enumeration date
10/26/2005
Last updated
04/23/2020
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