Individual
TIFFANY LACROSS HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3222 W AZEELE ST, TAMPA, FL 33609-3280
(813) 872-8491
(813) 872-7766
Mailing address
4033 TAMPA RD STE 101, OLDSMAR, FL 34677-3224
(813) 854-2003
(813) 855-2367
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME107265
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002605000
—
FL
Enumeration date
06/11/2007
Last updated
01/18/2017
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