Individual
DR. TIMOTHY C RUNYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1401 16TH ST N, ST PETERSBURG, FL 33704-4123
(727) 894-0794
(727) 895-1215
Mailing address
1401 16TH ST N, ST PETERSBURG, FL 33704-4123
(727) 894-0794
(727) 895-1215
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
PO1101
FL
213ER0200X
Radiology Podiatrist
PO1101
FL
213ES0000X
Sports Medicine Podiatrist
PO1101
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO1101
FL
332B00000X
Durable Medical Equipment & Medical Supplies
FP1101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041079900
—
FL
01
—
0854680001
DMERC
FL
Enumeration date
04/10/2006
Last updated
02/23/2016
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