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NPI Code Detail

MEDICARE: DR. TIFFANY S GARDNER PHARMD

MEDICARE: DR. TIFFANY S GARDNER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS47967FL

General Provider Information

NPI Number : 1588269203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY S GARDNER PHARMD
Provider Business Mailing Address
First Line : 2828 BOTANY PL
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32301-7117
Country : US
Telephone Number : 850-688-8786
Fax Number :
Provider Business Practice Location Address
First Line : 1819 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-3356
Country : US
Telephone Number : 850-576-0147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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