Healthcare Provider Details

I. General information

NPI: 1225305360
Provider Name (Legal Business Name): TIFFANY MARY BARBER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17796 SW 2ND ST
PEMBROKE PINES FL
33029-3923
US

IV. Provider business mailing address

3821 SW 160TH AVE APT 206
MIRAMAR FL
33027-4667
US

V. Phone/Fax

Practice location:
  • Phone: 954-438-7800
  • Fax:
Mailing address:
  • Phone: 954-303-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 26983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: