Provider Demographics
NPI:1457347775
Name:TIA, JILL MACAPOBRE (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MACAPOBRE
Last Name:TIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2805 MINUTEMAN LN
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-9504
Mailing Address - Country:US
Mailing Address - Phone:813-655-7882
Mailing Address - Fax:813-655-7882
Practice Address - Street 1:8415 BAYSHORE BLVD
Practice Address - Street 2:6TH MEDICAL GROUP, INTERNAL MEDICINE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-827-9011
Practice Address - Fax:813-827-9095
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD33893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine