Provider Demographics
NPI:1306487400
Name:BELL, TIFFANY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:BELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CENTREPARK BLVD APT 710
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7469
Mailing Address - Country:US
Mailing Address - Phone:561-631-6131
Mailing Address - Fax:
Practice Address - Street 1:50 COCOANUT ROW STE 100
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4027
Practice Address - Country:US
Practice Address - Phone:561-200-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112529363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant