Timothy L. Light D.O., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11758 Issued in FL

Legal business name

TIMOTHY L. LIGHT D.O., P.A.

Practice address

1573 S Fort Harrison Ave
Clearwater, FL 33756-2004

Phone

(727) 584-8777

Fax

(727) 216-6117

NPI assigned

Jul 18, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Timothy Lee Light, D.O.NPI 1912215807

Title

President

Phone

(727) 584-8777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Lee Light, D.O.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1912215807
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1306191028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 S FORT HARRISON AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562004",
            "telephone_number": "727-584-8777",
            "fax_number": "727-216-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 S FORT HARRISON AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562004",
            "telephone_number": "727-584-8777",
            "fax_number": "727-216-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY L. LIGHT D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-584-8777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Tifft, LMFT
• Jasmina Tihic
• Curtis Jamaal Tillman
• Maryellen Tilly, RDH BA
• Autumn Leigh Tilsworth
• Anne Tindall, MASTERS
• Courtney Tiner
• Steven Barry Tinsley, M.D.
• Thomas A Tirone, MD
• Sabrina Michelle Tisdale, HEALTHCARE PROVIDER

• Family Medicine Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.