MEDICARE: TIFFANY JEAN HIGHBRIDGE LMT

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
1	225700000X	Massage Therapist	MA44930	FL

General Provider Information

NPI Number	:	1609030527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY JEAN HIGHBRIDGE LMT

Provider Business Mailing Address
First Line	:	2665 W END RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7739
Country	:	US
Telephone Number	:	561-713-9199
Fax Number	:

Provider Business Practice Location Address
First Line	:	1195 N MILITARY TRL
Second Line	:	SUITE 5
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6058
Country	:	US
Telephone Number	:	561-640-0355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	07/10/2008

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