Provider Demographics
NPI:1528272077
Name:WOOD, TIFFANY L (DOM LAP, DIPL CM, CH)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:L
Last Name:WOOD
Suffix:
Gender:F
Credentials:DOM LAP, DIPL CM, CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 NW 14 CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-323-1432
Mailing Address - Fax:305-644-6343
Practice Address - Street 1:920 NW 14TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3624
Practice Address - Country:US
Practice Address - Phone:305-323-1432
Practice Address - Fax:305-644-6343
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1857171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC001BOtherBCBS