Healthcare Provider Details

I. General information

NPI: 1639087760
Provider Name (Legal Business Name): TIFFANY THAMPI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

2148 ZAMIA LOOP
LUTZ FL
33558-5501
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 914-433-9157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57857
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: