Provider Demographics
NPI:1376944439
Name:CANTY, TIFFANY (CNA/HHA/MA)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CANTY
Suffix:
Gender:F
Credentials:CNA/HHA/MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221862
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33422-1862
Mailing Address - Country:US
Mailing Address - Phone:561-202-7759
Mailing Address - Fax:
Practice Address - Street 1:1900 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3544
Practice Address - Country:US
Practice Address - Phone:561-202-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 106415376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide