Provider Demographics
NPI:1609260074
Name:SANDERS, TIPHANI (BS)
Entity Type:Individual
Prefix:
First Name:TIPHANI
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-4705
Mailing Address - Country:US
Mailing Address - Phone:813-464-4083
Mailing Address - Fax:813-354-3515
Practice Address - Street 1:4943 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-4705
Practice Address - Country:US
Practice Address - Phone:813-464-4083
Practice Address - Fax:813-354-3515
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator