Bonsack, Timothy Alan
Bonsack, Timothy Alan is an individual health care provider with primary practice located at 4516 N Armenia Ave , Tampa FL 33603-2732. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Bonsack, Timothy Alan can be contacted via phone (813) 348-6951.Contact Information
Primary practice address
4516 N Armenia Ave
Tampa FL 33603-2732
Phone: (813) 348-6951
Fax: (813) 348-6999
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | ME68441 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME68441 | Florida |
Profile Details
| NPI number | 1710952155 |
|---|---|
| LBN Legal business name | Bonsack, Timothy Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Apr 1st, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710952155 | NPPES |
| Florida | MEDICAID | 378134800 | |
| Florida | Other | 300063105 |
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