Provider Demographics
NPI:1114256732
Name:TIMKO HEARING CARE, P.L.
Entity Type:Organization
Organization Name:TIMKO HEARING CARE, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:TIMKO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:386-736-7192
Mailing Address - Street 1:844 N STONE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3208
Mailing Address - Country:US
Mailing Address - Phone:386-736-7192
Mailing Address - Fax:386-736-8520
Practice Address - Street 1:1185 DUNLAWTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-2905
Practice Address - Country:US
Practice Address - Phone:386-756-8225
Practice Address - Fax:386-767-0742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY393261QH0700X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment