MEDICARE: TIFFANY M HERRERA

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	225X00000X	Occupational Therapist	25320	FL

General Provider Information

NPI Number	:	1184466781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY M HERRERA

Provider Business Mailing Address
First Line	:	3000 OASIS GRAND BLVD APT 1805
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-1640
Country	:	US
Telephone Number	:	239-839-3024
Fax Number	:

Provider Business Practice Location Address
First Line	:	12651 MCGREGOR BLVD STE 501C
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4496
Country	:	US
Telephone Number	:	239-839-3024
Fax Number	:

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

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	12/01/2025

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Directions to “ TIFFANY M HERRERA ” Practice Location

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