Provider Demographics
NPI:1861776544
Name:NUNEZ-OCAMPO, TIFFANY W (PHARMD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:W
Last Name:NUNEZ-OCAMPO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1403
Mailing Address - Country:US
Mailing Address - Phone:850-995-7821
Mailing Address - Fax:850-995-7831
Practice Address - Street 1:4727 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1403
Practice Address - Country:US
Practice Address - Phone:850-995-7821
Practice Address - Fax:850-995-7831
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist