Provider Demographics
NPI:1710324330
Name:YARBROUGH, TIMOTHY (ARNP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:WILDLIGHT
Mailing Address - State:FL
Mailing Address - Zip Code:32097-0101
Mailing Address - Country:US
Mailing Address - Phone:561-889-9706
Mailing Address - Fax:561-694-7981
Practice Address - Street 1:280 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:WILDLIGHT
Practice Address - State:FL
Practice Address - Zip Code:32097-0101
Practice Address - Country:US
Practice Address - Phone:561-889-9706
Practice Address - Fax:561-694-7981
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP919829363L00000X
FLARNP9198259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner