Most Relevant Information
Provider Data
| NPI Number: | 1003313735 |
| Provider Name: | TIMOTHY NYCKOWSKI DO |
| Entity Type: | Individual |
| Taxonomy Code: | 207N00000X |
| Specialty: | Dermatology |
| License Number: | OS16707 |
Most Important Dates
| Enumeration Date: | 04/09/2018 |
| Last Updated: | 05/28/2024 |
Provider Practice Location
731 STIRLING CENTER PL UNIT 1931
LAKE MARY
FL
327465209
Practice Location Phone/Fax
| Phone: | 4074367375 |
| Fax: |
Provider Mailing Location
7560 RED BUG LAKE RD STE 1014
OVIEDO
FL
327656591
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |