Provider Demographics
NPI:1023190568
Name:HELMS, TIMOTHY LAVON (LDO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LAVON
Last Name:HELMS
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2268 WEDNESDAY ST # 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4334
Mailing Address - Country:US
Mailing Address - Phone:850-561-3937
Mailing Address - Fax:850-671-3937
Practice Address - Street 1:2268 WEDNESDAY ST # 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4334
Practice Address - Country:US
Practice Address - Phone:850-561-3937
Practice Address - Fax:850-671-3937
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO4416156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician