Provider Demographics
NPI:1568413193
Name:ORLANDO-WEBER, TIFFANY (DPM)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:ORLANDO-WEBER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 PLEASANT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4670
Mailing Address - Country:US
Mailing Address - Phone:216-534-2773
Mailing Address - Fax:513-858-7827
Practice Address - Street 1:6200 PLEASANT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-4670
Practice Address - Country:US
Practice Address - Phone:216-534-2773
Practice Address - Fax:513-858-7827
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003404213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2663792Medicaid
OHP00336325OtherMEDICARE RAILROAD
OH4183413Medicare PIN
OH3986320002Medicare NSC
OHP00336325OtherMEDICARE RAILROAD
OH2663792Medicaid
OH9326031Medicare PIN
OH4183411Medicare PIN