Healthcare Provider Details

I. General information

NPI: 1215408182
Provider Name (Legal Business Name): TIFINI AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 03/20/2021
Certification Date: 03/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 TRAILWOOD CT
TALLAHASSEE FL
32311-9389
US

IV. Provider business mailing address

6130 TRAILWOOD CT
TALLAHASSEE FL
32311-9389
US

V. Phone/Fax

Practice location:
  • Phone: 850-284-4760
  • Fax:
Mailing address:
  • Phone: 850-284-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: