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NPI Code Detail

MEDICARE: TIFFANY MARTIN APRN

MEDICARE: TIFFANY MARTIN APRN
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
1363LP0200XPediatric Nurse Practitioner11020622FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2UAE19OTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245967389
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY MARTIN APRN
Provider Business Mailing Address
First Line : 508 S HABANA AVE STE 340
Second Line :
City : TAMPA
State : FL
Zip : 33609-4191
Country : US
Telephone Number : 813-873-7367
Fax Number : 813-875-9722
Provider Business Practice Location Address
First Line : 508 S HABANA AVE STE 340
Second Line :
City : TAMPA
State : FL
Zip : 33609-4191
Country : US
Telephone Number : 813-873-7367
Fax Number : 813-875-9722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2022
Last Update Date : 12/03/2024

Similar Medicare Providers

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Practice Location Address:
508 S HABANA AVE STE 340
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Practice Location Address:
508 S HABANA AVE STE 340
TAMPA, FL
33609-4191
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Practice Fax:
1194415216 — KRISTIN SMITH MS
Practice Location Address:
508 S HABANA AVE STE 340
TAMPA, FL
33609-4191
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Practice Fax: 813-875-9722
1851139547 — JESSICA ZAHRAN APRN
Practice Location Address:
508 S HABANA AVE STE 340
TAMPA, FL
33609-4191
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Practice Fax:
1053148304 — NATALIE TURANICZO APRN
Practice Location Address:
508 S HABANA AVE STE 340
TAMPA, FL
33609-4191
Practice Phone: 813-873-7367
Practice Fax: 813-875-9722

Directions to “ TIFFANY MARTIN APRN” Practice Location

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