1184037103 NPI number — FAMILY SOLUTIONS TCM, INC

Table of content: (NPI 1184037103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184037103 NPI number — FAMILY SOLUTIONS TCM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY SOLUTIONS TCM, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184037103
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5798 S SEMORAN BLVD
Provider Second Line Business Mailing Address:
STE 115, BLDG F
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32822-4829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-765-8480
Provider Business Mailing Address Fax Number:
407-730-8492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5798 S SEMORAN BLVD
Provider Second Line Business Practice Location Address:
STE 115, BLDG F
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32822-4829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-765-8480
Provider Business Practice Location Address Fax Number:
407-730-8492
Provider Enumeration Date:
06/06/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DEL MORAL
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
407-765-8480

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)