Provider Demographics
NPI:1225102577
Name:CYMANSKI, TIMOTHY M (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:CYMANSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 49TH ST N STE C
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5237
Mailing Address - Country:US
Mailing Address - Phone:727-327-0721
Mailing Address - Fax:727-327-2875
Practice Address - Street 1:2150 49TH ST N STE C
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5237
Practice Address - Country:US
Practice Address - Phone:727-327-0721
Practice Address - Fax:727-327-2875
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014111N00000X
CO5792111NX0800X, 111NX0800X
FLCH11014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804385Medicare ID - Type Unspecified
COU54395Medicare UPIN