Healthcare Provider Details

I. General information

NPI: 1770078255
Provider Name (Legal Business Name): TIFFANY CARR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CELEBRATION PL
CELEBRATION FL
34747-4970
US

IV. Provider business mailing address

400 N BEECH ST APT 140
WINNSBORO TX
75494-2762
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT39386
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1366387
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: