Individual
TIMOTHY A NIELSEN
Active
Individual
TIMOTHY A NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0071829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32680
MEDICARE-PTAN/BOCA
FL
01
—
32680Z
MEDICARE-PTAN
FL
Enumeration date
07/28/2006
Last updated
04/30/2013
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