Provider Demographics
NPI:1609030527
Name:HIGHBRIDGE, TIFFANY JEAN (LMT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JEAN
Last Name:HIGHBRIDGE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 W END RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7739
Mailing Address - Country:US
Mailing Address - Phone:561-713-9199
Mailing Address - Fax:
Practice Address - Street 1:1195 N MILITARY TRL
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6058
Practice Address - Country:US
Practice Address - Phone:561-640-0355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA44930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist