Healthcare Provider Details

I. General information

NPI: 1194399105
Provider Name (Legal Business Name): TIFFANY EMILY CERDA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 FOREST HILL BLVD STE 4
WEST PALM BEACH FL
33406-6031
US

IV. Provider business mailing address

4733 W ATLANTIC AVE STE C-7
DELRAY BEACH FL
33445-3706
US

V. Phone/Fax

Practice location:
  • Phone: 561-357-9330
  • Fax:
Mailing address:
  • Phone: 561-995-0229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4451
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4451
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: