Provider Demographics
NPI:1932584836
Name:KRZYWDA, TIFFANI E
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:E
Last Name:KRZYWDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANI
Other - Middle Name:E
Other - Last Name:KRZYWDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:790 VETERANS WAY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-1000
Mailing Address - Country:US
Mailing Address - Phone:850-912-2116
Mailing Address - Fax:
Practice Address - Street 1:790 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-1000
Practice Address - Country:US
Practice Address - Phone:850-912-2116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist