Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tiffany Ballentine

Individual provider Registered Nurse · NPI 1558010694

Tiffany Ballentine is a Nurse Practitioner in Fort Myers, Florida. Qualified in 2021, 5 years ago. Practices with Three Oaks Family Medicine LLC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

9617 Gulf Research Ln
Fort Myers, FL 33912
Phone: (239) 418-0999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2500 Goodlette-Frank Rd N, Naples, FL 34103-4608 — (239) 418-0999

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 11018629 (FL)
Registered Nurse Taxonomy 163W00000X · Licence 9435094 (FL)

Record details

NPI number1558010694
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 23, 2022
Last updated in NPPESJuly 18, 2024
Certification dateJuly 18, 2024
Mailing address9617 Gulf Research Lane, Fort Myers, FL 33912

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Three Oaks Family Medicine Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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