Provider Demographics
NPI:1023066578
Name:TWEITO, TIMOTHY H (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:H
Last Name:TWEITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 N SYKES CREEK PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3491
Mailing Address - Country:US
Mailing Address - Phone:321-735-8800
Mailing Address - Fax:321-735-8898
Practice Address - Street 1:280 N SYKES CREEK PKWY STE B
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3491
Practice Address - Country:US
Practice Address - Phone:321-735-8800
Practice Address - Fax:321-735-8898
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13099207W00000X
WAMD00046436207W00000X
FLME149069207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8860191Medicare PIN
I11304Medicare UPIN