Healthcare Provider Details

I. General information

NPI: 1932701497
Provider Name (Legal Business Name): CPC BILLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MILITARY TRL STE 245
BOCA RATON FL
33431-6362
US

IV. Provider business mailing address

9500 NW 49TH CT
CORAL SPRINGS FL
33076-2465
US

V. Phone/Fax

Practice location:
  • Phone: 954-501-3861
  • Fax: 608-305-8874
Mailing address:
  • Phone: 954-501-3861
  • Fax: 608-305-8874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY WILLIAMSON
Title or Position: AUTHORIZED OFFICIAL
Credential: APRN
Phone: 954-501-3861