| Doctor Name: | TIFFANY RENEE COMERIE |
| NPI Number: | 1164822649 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PA9108164 |
| Business Practice Address: | 5000 W Oakland Park Blvd Lauderdale Lakes, FL - 333131503 |
| Business Phone Number: | 9542637262 |
| Business Fax Number: | |
| Mailing Address: | 6122 Grand Cypress Cir E, COCONUT CREEK |
| State: | FL |
| Postal Code: | 330732343 |
| Phone Number: | 9542637262 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2014 |
| NPI Last Update Date: | 09/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9108164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |