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

Tiffany Dyal

Individual provider Surgical Physician Assistant · NPI 1073009619

Tiffany Dyal is a Surgical Physician Assistant in Jacksonville, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

14546 Old Saint Augustine Rd Ste 409
Jacksonville, FL 32258-5473
Phone: (904) 388-6518
Fax: (904) 384-1005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 — (904) 308-2006

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9111506 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9111506 (FL)

Record details

NPI number1073009619
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 6, 2018
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024
Mailing addressPo Box 746647, Atlanta, GA 30374-6647

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