Provider Demographics
NPI:1437946985
Name:LEE, TIFFANY FAITH
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:FAITH
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14670 SW 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1725
Mailing Address - Country:US
Mailing Address - Phone:305-812-0807
Mailing Address - Fax:
Practice Address - Street 1:14670 SW 71ST AVE
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1725
Practice Address - Country:US
Practice Address - Phone:305-812-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program