Provider Demographics
NPI:1326627928
Name:ARSON, TIFFINY
Entity Type:Individual
Prefix:
First Name:TIFFINY
Middle Name:
Last Name:ARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 1ST AVE N
Mailing Address - Street 2:STE 2M PMB 1029
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8637
Mailing Address - Country:US
Mailing Address - Phone:813-729-3730
Mailing Address - Fax:
Practice Address - Street 1:3110 1ST AVE N
Practice Address - Street 2:STE 2M PMB 1029
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8637
Practice Address - Country:US
Practice Address - Phone:813-729-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
FL237534376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty