Tiffany Jade Harris Fraser, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS57850 Issued in FL

Practice address

14500 US Highway 301 S
Starke, FL 32091-7858

Phone

(904) 964-3290

NPI assigned

Aug 14, 2020

Last updated

Dec 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1073124863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 S SR 19",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "32177",
            "telephone_number": "386-328-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 US HIGHWAY 301 S",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320917858",
            "telephone_number": "904-964-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1565 County Road 220",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320037945",
            "country_code": "US",
            "telephone_number": "904-269-8142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRASER",
        "first_name": "TIFFANY",
        "middle_name": "JADE HARRIS",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS57850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynette Fodor
• Shannon Ford, PTA
• Brianna N Forsyth
• Dorothy Fox, RPH
• Charles James Franson Jr., D.O.
• Amanda Futch, LCSW
• Gainesville Emergency Medical Associates PA
• Jorge Gilete Sosa, MD
• Michael Clay Gilhooly, ARNP
• Junita Golden

• Pharmacist in Starke, FL
• Providers in Starke, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.