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General NPI Number Information
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NPI Number | 1952677411
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Entity Type | Organization
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Legal Business Name | TIGERTAIL EMERGENCY PHYSICIANS, LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 3663 S MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33133-4253
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Country | US
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Telephone | 973-251-1132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37871
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City | PHILADELPHIA
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State | PA
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Zip | 19101-0171
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KAREN VAUGHN
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Credential |
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Telephone | 404-450-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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