Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME68462 | FL |
NPI | 1003876251 |
---|---|
Provider Name | Timothy Edward Fee |
First Address | Jacksonville, FL 32216-0996 |
Second Address | Jacksonville, FL 32216-0996 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32210 | BCBS (01) | FL |
G44302 | (02) | FL |