Provider Demographics
NPI:1538209713
Name:MUSCARO, TIMOTHY (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:MUSCARO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 W BAY TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7045
Mailing Address - Country:US
Mailing Address - Phone:813-839-6999
Mailing Address - Fax:813-831-1670
Practice Address - Street 1:3502 W BAY TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7045
Practice Address - Country:US
Practice Address - Phone:813-839-6999
Practice Address - Fax:813-831-1670
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10807332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies