Provider Demographics
NPI:1003801135
Name:YEKO, TIMOTHY RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RAYMOND
Last Name:YEKO
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 1:5245 E FLETCHER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1126
Mailing Address - Country:US
Mailing Address - Phone:813-914-7304
Mailing Address - Fax:813-676-8812
Practice Address - Street 1:5245 E FLETCHER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1126
Practice Address - Country:US
Practice Address - Phone:813-914-7304
Practice Address - Fax:813-676-8812
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55059207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C46686Medicare UPIN
FL0055059Medicare ID - Type Unspecified