Tiffany, Maranda S

Tiffany, Maranda S is an individual health care provider with primary practice located at 26 N Beach St Suite B, Ormond Beach FL 32174-5663. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Tiffany, Maranda S can be contacted via phone (386) 673-0201.

Contact Information

Primary practice address
26 N Beach St Suite B Ormond Beach FL 32174-5663
Phone: (386) 673-0201
Fax: (386) 677-8143
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT22240 Florida

Profile Details

NPI number 1275725319
LBN Legal business name Tiffany, Maranda S
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2007
Last updated Jan 20th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275725319 NPPES
Florida Other Y04EA BCBS NON-PAR

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