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Tiki Stafford
Lodging Provider in Jacksonville, Florida
NPI 1427234152

Tiki Stafford is a Lodging Provider based in Jacksonville, FL. Tiki Stafford practices in Jacksonville, FL. The NPI Number for Tiki Stafford is 1427234152 and holds a License No. AL11189 (Florida).

The current practice location address for Tiki Stafford is 523 Fern St, Jacksonville, FL and can be reached out via phone at 904-764-2891.

Location: 523 Fern St, Jacksonville, FL, 32206-6238
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Provider Profile Details
NPI Number
1427234152
Provider Name
Tiki Stafford
Credential
Provider Entity Type
Individual
Gender
Female
Address
523 Fern St, Jacksonville, FL, 32206-6238
Phone Number
904-764-2891
Fax Number
Provider Enumeration Date
01/11/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AL11189 01 FL AHCA
institution
Provider Business Practice Location Address Details
Address
523 Fern St
City
State
Zip
32206-6238
Phone Number
904-764-2891
Fax Number
person
Provider Business Mailing Address Details
Address
523 Fern St
City
State
Zip
32206-6238
Phone Number
904-764-2891
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
License No.
AL11189 (Florida)
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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