Provider Demographics
NPI:1831185685
Name:MCGEE, TIFFANI ONDREA (PA)
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:ONDREA
Last Name:MCGEE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 JACKSON ST N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1405
Mailing Address - Country:US
Mailing Address - Phone:727-329-1600
Mailing Address - Fax:727-329-1694
Practice Address - Street 1:560 JACKSON ST N
Practice Address - Street 2:SUITE 100
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1405
Practice Address - Country:US
Practice Address - Phone:727-329-1600
Practice Address - Fax:727-329-1694
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3653363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6928ZMedicare ID - Type Unspecified
P50863Medicare UPIN