Healthcare Provider Details

I. General information

NPI: 1043448046
Provider Name (Legal Business Name): TIFFANY SIZEMORE DI PIETRO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 SE 18TH CT
FORT LAUDERDALE FL
33316-2829
US

IV. Provider business mailing address

305 SE 18TH CT
FORT LAUDERDALE FL
33316-2829
US

V. Phone/Fax

Practice location:
  • Phone: 561-716-7943
  • Fax:
Mailing address:
  • Phone: 561-716-7943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS11050
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS11050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: