Provider Demographics
NPI:1164746053
Name:BIEBER, TIMOTHY JOHN (MPT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:BIEBER
Suffix:
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 1:1705 SAND DOLLAR WAY
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2724
Mailing Address - Country:US
Mailing Address - Phone:772-473-7254
Mailing Address - Fax:
Practice Address - Street 1:1705 SAND DOLLAR WAY
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2724
Practice Address - Country:US
Practice Address - Phone:772-473-7254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-21
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist