Provider Demographics
NPI:1003366949
Name:LAMARCA, TIFFANY KRISTINE (FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:KRISTINE
Last Name:LAMARCA
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 ENGLEWOOD RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-1749
Mailing Address - Country:US
Mailing Address - Phone:941-473-8881
Mailing Address - Fax:941-475-0801
Practice Address - Street 1:2061 ENGLEWOOD RD STE 5
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223
Practice Address - Country:US
Practice Address - Phone:941-473-8881
Practice Address - Fax:941-475-0801
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9411338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily