Provider Demographics
NPI:1508979246
Name:TIMKO, JAMES R (MA,CCC-A)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:TIMKO
Suffix:
Gender:M
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:844 N STONE ST STE 206
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3208
Practice Address - Country:US
Practice Address - Phone:386-736-7192
Practice Address - Fax:386-736-8520
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY393231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist