Provider Demographics
NPI:1518682079
Name:COOK, TIFFANY S (RN)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:S
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12424 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3249
Mailing Address - Country:US
Mailing Address - Phone:407-579-4211
Mailing Address - Fax:
Practice Address - Street 1:12424 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3249
Practice Address - Country:US
Practice Address - Phone:407-579-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9315668163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse