Provider Demographics
NPI:1326627928
Name:ARSON, TIFFINY
Entity type:Individual
Prefix:
First Name:TIFFINY
Middle Name:
Last Name:ARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 1ST AVE N
Mailing Address - Street 2:STE 2M PMB 1029
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8637
Mailing Address - Country:US
Mailing Address - Phone:813-729-3730
Mailing Address - Fax:
Practice Address - Street 1:3110 1ST AVE N
Practice Address - Street 2:STE 2M PMB 1029
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8637
Practice Address - Country:US
Practice Address - Phone:813-729-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1740859438OtherNPPES