Individual
FELICIA JEAN TIMMERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3200 S UNIVERSITY DR BLDG 2, DAVIE, FL 33328-2018
(954) 262-4200
Mailing address
660 S EUCLID AVE # 8096, SAINT LOUIS, MO 63110-1010
(314) 747-5380
(314) 362-5590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010899
IL
152W00000X
Optometrist
2017031245
MO
152W00000X
Optometrist
6326
OH
152W00000X
Optometrist
Primary
OPC5452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046010899
—
IL
Enumeration date
06/12/2014
Last updated
11/05/2018
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