Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 11014 | FL |
Y | 111N00000X | Chiropractor | CH11014 | FL |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 5792 | CO |
NPI | 1225102577 |
---|---|
Provider Name | Timothy M Cymanski |
First Address | St Petersburg, FL 33710-5237 |
Second Address | St Petersburg, FL 33710-5237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U54395 | (02) | CO |