Healthcare Provider Details

I. General information

NPI: 1104751528
Provider Name (Legal Business Name): TIFFANY HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39249 SPARKMAN RD
DADE CITY FL
33525-7043
US

IV. Provider business mailing address

39249 SPARKMAN RD
DADE CITY FL
33525-7043
US

V. Phone/Fax

Practice location:
  • Phone: 352-467-0550
  • Fax:
Mailing address:
  • Phone: 352-467-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT16636
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: