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General NPI Number Information
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NPI Number | 1104331792
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Entity Type | Individual
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Provider Name | TIFFANY HARRIS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 03/07/2018
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Provider Practice Location Address
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Address Line | 612 CALHOUN AVE
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City | SEFFNER
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State | FL
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Zip | 33584-3617
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Country | US
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Telephone | 813-473-9510
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Fax | 813-435-3246
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Provider Business Mailing Address
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Address Line | PO BOX 1771
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City | SEFFNER
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State | FL
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Zip | 33583-1771
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Country | US
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Telephone | 813-473-9510
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Fax | 813-435-3246
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 23494
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License Number State | FL
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