Provider Demographics
NPI:1184998833
Name:TIFFANY SIZEMORE DO LLC
Entity type:Organization
Organization Name:TIFFANY SIZEMORE DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DI PIETRO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-716-7943
Mailing Address - Street 1:305 SE 18TH CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2829
Mailing Address - Country:US
Mailing Address - Phone:561-716-7943
Mailing Address - Fax:
Practice Address - Street 1:1409 SE 1ST AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1805
Practice Address - Country:US
Practice Address - Phone:561-716-7943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty