Provider Demographics
NPI:1396087490
Name:HILL, TARYN ANN (MD MED)
Entity type:Individual
Prefix:DR
First Name:TARYN
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:MD MED
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:ANN
Other - Last Name:TIETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:DEPT 7835, STE 504
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-8917
Mailing Address - Fax:
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:DEPT 7835, STE 504
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-8917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME128597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program