Provider Demographics
NPI:1255473518
Name:WOZNIAK, TIFFANY (PT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:K
Other - Last Name:FRICKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8020 RIO BELLA PL
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2210
Mailing Address - Country:US
Mailing Address - Phone:941-557-3108
Mailing Address - Fax:
Practice Address - Street 1:8020 RIO BELLA PL
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-2210
Practice Address - Country:US
Practice Address - Phone:941-557-3108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 28840225100000X
FLPT28840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT 28840OtherPT LICENSE
FLPT 28840OtherPT LICENSE