Provider Demographics
NPI:1477315976
Name:TIMONERA, CHELSEA NOELLE MIRA (PA-C)
Entity type:Individual
Prefix:
First Name:CHELSEA NOELLE
Middle Name:MIRA
Last Name:TIMONERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 S FALKENBURG RD STE 205
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-2594
Mailing Address - Country:US
Mailing Address - Phone:813-533-5522
Mailing Address - Fax:813-533-5511
Practice Address - Street 1:3140 S FALKENBURG RD STE 205
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-2594
Practice Address - Country:US
Practice Address - Phone:813-533-5522
Practice Address - Fax:813-533-5511
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9118451363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant