Individual
TIMOTHY A NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2620 S SEACREST BLVD, BOYNTON BEACH, FL 33435
(561) 737-4888
(561) 737-5221
Mailing address
2620 S SEACREST BLVD, BOYNTON BEACH, FL 33435-7534
(561) 737-4888
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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