Individual
TIMOTHY DAVID WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3920 ROSEWOOD WAY, ORLANDO, FL 32808-1033
(407) 730-3859
Mailing address
3920 ROSEWOOD WAY, ORLANDO, FL 32808-1033
(407) 730-3859
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
PTA 24035
FL
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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