Individual
DR. TIMOTHY ALAN BONSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4516 N ARMENIA AVE, TAMPA, FL 33603-2732
(813) 348-6951
(813) 348-6999
Mailing address
PO BOX 403444, ATLANTA, GA 30384-3444
(813) 348-6951
(813) 348-6999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME68441
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME68441
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300063105
RR MCR
FL
05
—
378134800
—
FL
Enumeration date
02/21/2006
Last updated
04/01/2010
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