Individual
TIMOTHY J KINSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3175 HARBOR BLVD, PORT CHARLOTTE, FL 33952-6729
(941) 627-6465
Mailing address
4400 DEERWOOD CT, BONITA SPRINGS, FL 34134-8763
(216) 544-5218
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
159050
FL
2085R0001X
Radiation Oncology Physician
35-073919
OH
2085R0001X
Radiation Oncology Physician
39665
MA
2085R0001X
Radiation Oncology Physician
Primary
MD13152
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000140688
ANTHEM
OH
01
—
000000224291
UNISON
OH
01
—
000000529630
ANTHEM
OH
01
—
1601202
UHC
OH
05
—
2084748
—
OH
01
—
2138749
AETNA
OH
01
—
363708
WELLCARE
OH
01
—
744783
BUCKEYE
—
01
—
9809555
AETNA PIN
RI
Enumeration date
07/10/2006
Last updated
01/16/2023
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