MR. TIMOTHY LEE WATERS JR. (NPI# 1154705051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154705051 |
Entity Type | Individual |
Full Name | MR. TIMOTHY LEE WATERS JR. |
Credential | ARNP |
Practice Address |
13340 Metro Pkwy Ste 400 Fort Myers FL 33966-4818 |
Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
Practice Telephone | 2393431105 |
Practice Fax Number | 2393431106 |
Mailing Telephone | 2393431105 |
Mailing Fax Number | 2393431106 |
Enumeration Date | 2015-07-10 |
Last Update Date | 2020-04-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9325102 | FL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
ARNP 9325102 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN9325102 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 016793000 | 05 | |
FL | CIGNA | 7061863 | 01 |
FL | FREEDOM | P1036301 | 01 |
FL | OPTIMUM | P973771 | 01 |
FL | AETNA | 4857567 | 01 |
FL | AVMED | 398643 | 01 |
FL | WELLCARE | 1254561 | 01 |
FL | RR MEDICARE | P01652219 | 01 |
FL | BCBS | Y0SY4 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437696994 | Timothy David Waters | Counselor | 66 S 360 E, American Fork, UT 84003-2590 | 2017-01-23 |
1083813885 | Timothy Waters | Internal Medicine | 600 Northern Blvd, Albany, NY 12204-1004 | 2007-07-12 |
1952397465 | Timothy Waters | Physical Therapist | 1441 Kapiolani Blvd, Suite 1113, Honolulu, HI 96814-4402 | 2005-09-21 |
Street Address |
13340 METRO PKWY STE 400 |
City | FORT MYERS |
State | FL |
Zip Code | 33966-4818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689640732 | Ann V Brock | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2006-02-28 |
1770122996 | Victoria Kern | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2020-01-06 |
1205474020 | Stacy Wlliam Szczygiel Jr. | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2019-12-11 |
1356850390 | Steven Stallens Hagewood | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2017-09-21 |
1962928994 | Miguel Angel Gonzalez | Clinical Nurse Specialist | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2017-08-22 |
1376904334 | Keith Alan Gillis | Nurse Practitioner | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2016-03-17 |
1700241858 | Mini Mathew | Nurse Practitioner | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2015-12-16 |
1972988673 | Maya Gopi | Nurse Practitioner | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2015-07-23 |
1578802724 | Debra J Peck | Nurse Practitioner | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2013-02-07 |
1427382712 | Dolan K Abu Aouf | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2009-09-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
Find all providers in zip 33966 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790384154 | Melissa Connors | Nurse Practitioner | 15609 Fiddlesticks Blvd, Fort Myers, FL 33912-3902 | 2020-10-18 |
1982202412 | Amanda Shively | Nurse Practitioner | 7951 Reflection Cove Dr Apt 102, Fort Myers, FL 33907-6560 | 2020-10-16 |
1205433828 | Kenneth Midoneck | Nurse Practitioner | 4445 Kings Barn Ct Unit 305, Fort Myers, FL 33916-8031 | 2020-10-06 |
1881218246 | Miraleen Patel | Nurse Practitioner | 5710 Trailwinds Dr Apt 524, Fort Myers, FL 33907-8338 | 2020-06-02 |
1194350348 | Zuleima Lozada | Nurse Practitioner | 13691 Metro Pkwy Ste 110a, Fort Myers, FL 33912-4348 | 2020-03-09 |
1962034686 | Kathleen A Shelton | Nurse Practitioner | 9371 Cypress Lake Dr Ste 16, Fort Myers, FL 33919-4945 | 2020-02-11 |
1275173155 | Optimal Healing Healthcare Services, LLC | Nurse Practitioner | 10143 Chesapeake Bay Dr, Fort Myers, FL 33913-9184 | 2020-01-08 |
1033760731 | Jaclyn Mason | Nurse Practitioner | 18431 Hawthorne Rd, Fort Myers, FL 33967-3276 | 2019-09-24 |
1245894419 | Sonya Brielle Hayhurst | Nurse Practitioner | 16026 Via Solera Cir Apt 102, Fort Myers, FL 33908-7706 | 2019-04-23 |
1083175871 | Jackelin Smith | Nurse Practitioner | 10685 Essex Square Blvd, Fort Myers, FL 33913-2612 | 2019-03-26 |
Find all providers in FORT MYERS |
City | FORT MYERS |
Zip Code | 33966 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.