IndividualActive
Timothy Peterson
NPI 1861198202 · Physician Assistant · Malabar, FL
Provider details
- NPI number
- 1861198202
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Student, Health Care
Practice location
730 Malabar Rd Ste B
Malabar, FL 32950-3140
Phone: (800) 465-3203
Approximate (ZIP-level) locationGet directions
Mailing address
3200 S University Dr
Davie, FL 33328-2018
Additional practice locations (1)
- 3200 S University DrDavie, FL 33328-2018Phone: (954) 262-1250
Registry dates
- Enumerated
- 2023-02-07
- Last updated
- 2024-09-13
- Certified
- 2024-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.