TIFFANY JACK (NPI# 1114352630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114352630 |
Entity Type | Individual |
Full Name | TIFFANY JACK |
Credential | HIS |
Practice Address |
1130 Bichara Blvd Lady Lake FL 32159-7716 |
Mailing Address |
215 Shuman Blvd Suite 401 Naperville IL 60563-8458 |
Practice Telephone | 3527504327 |
Practice Fax Number | 3527502410 |
Mailing Telephone | 6303035380 |
Mailing Fax Number | 9783136824 |
Enumeration Date | 2013-09-04 |
Last Update Date | 2016-06-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 237700000X | Hearing Instrument Specialist | AS4900 | FL | Speech, Language and Hearing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114371838 | Tiffany Jack | Registered Nurse | 801 E 241st St, Bronx, NY 10470-1303 | 2016-04-19 |
Street Address |
1130 BICHARA BLVD |
City | LADY LAKE |
State | FL |
Zip Code | 32159-7716 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225085673 | James Michael Davenport | Audiologist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2006-05-30 |
1003274903 | Jordyn Mckee | Hearing Instrument Specialist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2016-02-05 |
1659624807 | Connect Hearing, Inc. | Audiologist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2012-10-24 |
1952553943 | Megan Leigh Stout | Audiologist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2008-10-21 |
1336295682 | Ann L Messmer | Audiologist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2007-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306451216 | Lindsey Porubcan | Physician Assistant | 990 South Us Highway 441/27, Lady Lake, FL 32159 | 2020-09-09 |
1073134979 | Michael Robert Frates | Dietitian, Registered | 900 Cr 466, Lady Lake, FL 32159 | 2020-05-01 |
1346800364 | Barbara Conrad | Social Worker | 906 Orchid Street, Lady Lake, FL 32159 | 2019-06-20 |
1962977165 | Curelogics Wound Care and Hyperbaric LLC | Registered Nurse | 809 County Road 466, Unit C-201, Lady Lake, FL 32159 | 2018-10-04 |
1346736907 | Caroline Butler | Physician Assistant | 805 E. Cr 466, Lady Lake, FL 32159 | 2018-07-06 |
1033609607 | Cyrus Immanuel Macalisang Doroy | Physical Therapist | 6340 County Rd 466, Suite 733, Lady Lake, FL 32159 | 2018-05-18 |
1962999680 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 1501 Us Hwy 441, Villages, FL 32159 | 2018-04-18 |
1538683198 | Cathleen Laurel Civiello | Psychologist | 929 H. Hwy 441, Suite 404, Lady Lake, FL 32159 | 2017-07-26 |
1649709015 | Adria Young | Optometrist | 801 Cr 466, Suite 102 Sunset Plaza, Lady Lake, FL 32159 | 2017-06-08 |
1891222527 | Center for Hope and Healing, LLC | Social Worker | 804 Hwy 466, Lady Lake, FL 32159 | 2017-05-12 |
Find all providers in zip 32159 |
Taxonomy Code | 237700000X |
Grouping | Speech, Language and Hearing Service Providers |
Classification | Hearing Instrument Specialist |
Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568978930 | Traci Gamble | Hearing Instrument Specialist | 702 N Us Highway 441, Lady Lake, FL 32159-3194 | 2017-12-21 |
1215476817 | Mefl,llc | Hearing Instrument Specialist | 566 N Us Highway 441, Ste E, Lady Lake, FL 32159-3776 | 2017-02-15 |
1295133569 | Matthew Kehoe | Hearing Instrument Specialist | 877-b N. Us Hwy 441, Lady Lake, FL 32159 | 2014-12-18 |
1417292400 | Derry Vansicklen | Hearing Instrument Specialist | 755 N Us Highway 441, Lady Lake, FL 32159-3196 | 2012-12-03 |
1003186024 | Paul J Campoamor | Hearing Instrument Specialist | 877-b N Us Hwy 441, Lady Lake, FL 32159 | 2012-01-06 |
1063434512 | Kimberly Scopino | Hearing Instrument Specialist | 860 Avenida Central, Lady Lake, FL 32159 | 2006-07-24 |
1003274903 | Jordyn Mckee | Hearing Instrument Specialist | 1130 Bichara Blvd, Lady Lake, FL 32159-7716 | 2016-02-05 |
1962805218 | Craig E. Schatzberg | Hearing Instrument Specialist | 755 N Us Highway 441, Lady Lake, FL 32159-3196 | 2014-10-01 |
1295001147 | Jeffrey J Pralle | Hearing Instrument Specialist | 877 B N Us Hwy 441, Lady Lake, FL 32159 | 2012-03-26 |
1780613182 | Thomas Mark Eller | Hearing Instrument Specialist | 3399 Wedgewood Ln, Lady Lake, FL 32162-7180 | 2006-06-30 |
Find all providers in LADY LAKE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.