Provider Demographics
NPI:1629295126
Name:KYBURZ, TIMOTHY C (RPH)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:C
Last Name:KYBURZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N GOLF HARBOR PATH
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-1952
Mailing Address - Country:US
Mailing Address - Phone:352-344-2871
Mailing Address - Fax:
Practice Address - Street 1:127 N GOLF HARBOR PATH
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-1952
Practice Address - Country:US
Practice Address - Phone:352-344-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022673183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist