Provider Demographics
NPI:1518071109
Name:LOY, TIMOTHY P (PT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:P
Last Name:LOY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9216
Mailing Address - Country:US
Mailing Address - Phone:941-918-2947
Mailing Address - Fax:941-306-4772
Practice Address - Street 1:696 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9216
Practice Address - Country:US
Practice Address - Phone:941-918-2947
Practice Address - Fax:941-306-4772
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009400000Medicaid
SCTH1410Medicaid
FL009400000Medicaid