Individual
DR. CLIFTON N TIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
735 N 6TH AVE, WAUCHULA, FL 33873-2002
(863) 773-3322
(863) 773-6458
Mailing address
735 N 6TH AVE, WAUCHULA, FL 33873-2002
(863) 773-3322
(863) 773-6458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078175401
—
FL
01
—
19485
BLUE CROSS BLUE SHIELD
FL
01
—
P00085223
RAILROAD MEDICARE
FL
Enumeration date
09/12/2005
Last updated
04/22/2011
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