Waters, Timothy Lee
Waters, Timothy Lee is an individual health care provider with primary practice located at 16271 Bass Rd , Fort Myers FL 33908-3616. He recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is his primary health care specialty. Waters, Timothy Lee can be contacted via phone (239) 985-1925.Contact Information
Primary practice address
16271 Bass Rd
Fort Myers FL 33908-3616
Phone: (239) 985-1925
Fax: (239) 468-7929
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | ARNP9325102 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | ARNP 9325102 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | APRN9325102 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN9325102 | Florida |
Profile Details
| NPI number | 1154705051 |
|---|---|
| LBN Legal business name | Waters, Timothy Lee |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2015 |
| Last updated | Oct 11th, 2023 - about 3 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 | 1154705051 | NPPES |
| Florida | Other | 1254561 | WELLCARE |
| Florida | Other | P973771 | WELLCARE |
| Florida | Other | 398643 | WELLCARE |
| Florida | MEDICAID | 016793000 | WELLCARE |
| Florida | Other | 4857567 | WELLCARE |
| Florida | Other | P1036301 | WELLCARE |
| Florida | Other | Y0SY4 | WELLCARE |
| Florida | Other | 7061863 | WELLCARE |
| Florida | Other | P01652219 | WELLCARE |
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