Provider Demographics
NPI:1518948272
Name:DUNLEVY, TIMOTHY M (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:DUNLEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 FIRST AVENUE SOUTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4516
Mailing Address - Country:US
Mailing Address - Phone:727-341-0551
Mailing Address - Fax:727-341-0332
Practice Address - Street 1:6827 FIRST AVENUE SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-4516
Practice Address - Country:US
Practice Address - Phone:727-341-0551
Practice Address - Fax:727-341-0332
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90735207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304555OtherAVMED
FL1122688OtherAMERIGROUP
FL49580OtherBCBS FL
FL4799071OtherCIGNA
FL270640700Medicaid
FL3624154OtherAETNA
H23782Medicare UPIN