Provider Demographics
NPI:1306019021
Name:TIMOTHY T. MCLAUGHLIN, M.D., P.A.
Entity Type:Organization
Organization Name:TIMOTHY T. MCLAUGHLIN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-785-4715
Mailing Address - Street 1:529 OLD OAK CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-5869
Mailing Address - Country:US
Mailing Address - Phone:727-785-4715
Mailing Address - Fax:
Practice Address - Street 1:529 OLD OAK CIR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5869
Practice Address - Country:US
Practice Address - Phone:727-785-4715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45858900Medicaid
FL45858900Medicaid