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Individual

DR. TIMOTHY LOINE HONDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(954) 288-0169
Mailing address
1244 HARBOUR POINT DR, PORT ORANGE, FL 32127-5608
(954) 288-0169

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME31124
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
H3451
NM
Enumeration date
12/27/2012
Last updated
01/03/2023
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