Provider Demographics
NPI:1265593644
Name:TIMMONS, BATINA (MS, RD, LD, LN)
Entity type:Individual
Prefix:
First Name:BATINA
Middle Name:
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:MS, RD, LD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 SHADOW PINE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8342
Mailing Address - Country:US
Mailing Address - Phone:813-924-0676
Mailing Address - Fax:813-949-3214
Practice Address - Street 1:2017 SHADOW PINE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8342
Practice Address - Country:US
Practice Address - Phone:813-924-0676
Practice Address - Fax:813-949-3214
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3718133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH749AMedicare Oscar/Certification