Healthcare Provider Details

I. General information

NPI: 1841938115
Provider Name (Legal Business Name): TIFFANY GEORGINA CAMPBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 JOE DIMAGGIO DR
HOLLYWOOD FL
33021-5402
US

IV. Provider business mailing address

1005 JOE DIMAGGIO WAY 4TH FLOOR, SKYWALK- GME PEDIATRICS
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-5324
  • Fax:
Mailing address:
  • Phone: 954-265-4481
  • Fax: 954-276-0361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME173345
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: