TIMOTHY PINETREE LARSEN (NPI# 1770926032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770926032 |
| Entity Type | Individual |
| Full Name | TIMOTHY PINETREE LARSEN |
| Credential | DNP |
| Practice Address |
3434 Hancock Bridge Pkwy Ste 309 North Fort Myers FL 33903-7099 |
| Mailing Address |
2675 Winkler Ave Fl 2 Fort Myers FL 33901-9342 |
| Practice Telephone | 8556748800 |
| Practice Fax Number | 2395994126 |
| Mailing Telephone | 8778563774 |
| Mailing Fax Number | 2395992612 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2020-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN3307382 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
COA.14394-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | YC9Q0 | 01 |
| FL | 104893800 | 05 | |
| FL | MEDICARE | LD356 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1735 Sw Health Pkwy Ste 201, Naples, FL 341090421 | 8556748800 | 2393312247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477845337 | Timothy Raymond Larsen | Internal Medicine | 1725 W Harrison St Ste 1159, Chicago, IL 60612 | 2011-05-11 |
| 1306070222 | Timothy Christian Larsen | Pediatrics | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2009-05-06 |
| 1760417760 | Timothy C Larsen | Anesthesiology | 1818 N Meade St, Appleton, WI 54911-3454 | 2006-07-11 |
| 1942245576 | Timothy J Larsen | Emergency Medicine | 988102 Nebraska Medical Ctr, Omaha, NE 68198-8102 | 2006-06-18 |
| 1881691079 | Timothy George Larsen | Pharmacist | 106 1st St S, Yelm, WA 98597-7700 | 2005-07-01 |
| Street Address |
3434 HANCOCK BRIDGE PKWY STE 309 |
| City | NORTH FORT MYERS |
| State | FL |
| Zip Code | 33903-7099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194376590 | Tls Consulting, LLC | Community/Behavioral Health | 13971 N. Cleveland Avenue #9, North Fort Myers, FL 33903 | 2019-09-26 |
| 1710537857 | Mariel Hernandez | Nurse Practitioner | 16251 N Cleveland Ave Ste 12, North Fort Myers, FL 33903 | 2019-09-19 |
| 1003308644 | Brandon Paige | Behavior Technician | 4085 Hancock Bridge Pkwy Unit 101, North Fort Myers, FL 33903 | 2018-05-30 |
| 1386176253 | Annette Porter | Clinic/Center | 995 Pondella Rd., North Fort Myers, FL 33903 | 2017-03-30 |
| 1972873883 | Apinya Suppatkul | Pharmacist | 17050 N Tamiami Trl, Fort Myers, FL 33903 | 2012-01-09 |
| 1932340536 | Jessica Winter Poe | Dentist | 19001north Tamiami Trail, Suite #3171, North Fort Myers, FL 33903 | 2009-03-12 |
| 1710127055 | Northland Hearing Centers, Inc. | Hearing Aid Equipment | 13240 N. Cleveland Ave., Suite 12, North Ft. Myers, FL 33903 | 2009-02-26 |
| 1013031038 | Mark B. Gorby | Dentist | 14731 N. Cleveland Ave., Suite 1 Community Dental Care, N. Fort Myers, FL 33903 | 2007-03-16 |
| 1285704882 | Jon L. Rauch | Dentist | 19001 N. Tamiami Trail, N. Ft Myers, FL 33903 | 2006-11-09 |
| 1639254188 | Paradise Medical Center | Pediatrics | 1890 North Tamiami Trail, #d2, North Fort Myers, FL 33903 | 2006-10-25 |
| Find all providers in zip 33903 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568803286 | Laura Ann Hollywood | Nurse Practitioner | 4250 Hatton Rogers Ln, North Fort Myers, FL 33903-7813 | 2013-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | NORTH FORT MYERS |
| Zip Code | 33903 |
Please comment or provide details below to improve the information on TIMOTHY PINETREE LARSEN.
| 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.