Provider Demographics
NPI:1346559481
Name:BISHOP, TIFFANY JANE MARIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:JANE MARIE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11224 PARK BLVD., N
Mailing Address - Street 2:CORA REHABILITATION
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772
Mailing Address - Country:US
Mailing Address - Phone:727-394-0949
Mailing Address - Fax:727-394-7031
Practice Address - Street 1:11224 PARK BLVD., N
Practice Address - Street 2:CORA REHABILITATION
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772
Practice Address - Country:US
Practice Address - Phone:727-394-0949
Practice Address - Fax:727-394-7031
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206637225100000X
FLPT27384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist