Provider Demographics
NPI:1366525933
Name:TOWARD, TIMOTHY ROBERT II (MPT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:TOWARD
Suffix:II
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 WINDING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3739
Mailing Address - Country:US
Mailing Address - Phone:561-202-7047
Mailing Address - Fax:561-972-7066
Practice Address - Street 1:6120 WINDING LAKE DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3739
Practice Address - Country:US
Practice Address - Phone:561-202-7047
Practice Address - Fax:561-972-7066
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY048POtherBCBS INDIVIDUAL #
FL889096000Medicaid
FL11914OtherPT NUMBER
FLY048POtherBCBS INDIVIDUAL #