Provider Demographics
NPI:1568222917
Name:TIMBOL, FRANZ BANTA (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:FRANZ
Middle Name:BANTA
Last Name:TIMBOL
Suffix:
Gender:M
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUCHULA
Mailing Address - State:FL
Mailing Address - Zip Code:33873-3408
Mailing Address - Country:US
Mailing Address - Phone:863-767-8333
Mailing Address - Fax:863-767-8334
Practice Address - Street 1:524 CARLTON ST
Practice Address - Street 2:
Practice Address - City:WAUCHULA
Practice Address - State:FL
Practice Address - Zip Code:33873-3408
Practice Address - Country:US
Practice Address - Phone:863-767-8333
Practice Address - Fax:863-767-8334
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily