MEDICARE: TISHA PIERRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW10949	FL

General Provider Information

NPI Number	:	1184034381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TISHA PIERRE

Provider Business Mailing Address
First Line	:	700 S ROYAL POINCIANA BLVD STE 300
Second Line	:	SUITE 300
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-6667
Country	:	US
Telephone Number	:	305-668-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 S ROYAL POINCIANA BLVD STE 300
Second Line	:	SUITE 300
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-6667
Country	:	US
Telephone Number	:	305-668-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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Directions to “ TISHA PIERRE ” Practice Location

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