Healthcare Provider Details

I. General information

NPI: 1174829451
Provider Name (Legal Business Name): DEBORAH TILLMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW 27TH AVE
MIAMI FL
33142-5881
US

IV. Provider business mailing address

780 SW 9TH ST
FLORIDA CITY FL
33034-5639
US

V. Phone/Fax

Practice location:
  • Phone: 305-637-4500
  • Fax:
Mailing address:
  • Phone: 407-489-4815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 3088252
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP 3088252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: