Provider Demographics
NPI:1376014225
Name:MCNEW, TIFFANY LEE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LEE
Last Name:MCNEW
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BAHAMA RD
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4113
Mailing Address - Country:US
Mailing Address - Phone:305-522-0054
Mailing Address - Fax:
Practice Address - Street 1:48 HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2006
Practice Address - Country:US
Practice Address - Phone:305-853-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist