1881634152 NPI number — TENDER LOVING CARE HEALTH CARE SERVICES OF FLORIDA, LLC

Table of content: MR. THOMAS L BITHELL D.C. (NPI 1730257734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881634152 NPI number — TENDER LOVING CARE HEALTH CARE SERVICES OF FLORIDA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENDER LOVING CARE HEALTH CARE SERVICES OF FLORIDA, LLC
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:
TENDER LOVING CARE
Provider Other Organization Name Type Code:
3
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:
1881634152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1983 MARCUS AVE
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
LAKE SUCCESS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11042-1016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-358-1000
Provider Business Mailing Address Fax Number:
516-327-8636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VILLAGE GREEN 9342 US 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT ST. LUCIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-335-3255
Provider Business Practice Location Address Fax Number:
772-335-5697
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DERR
Authorized Official First Name:
WIKLLARD
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
516-358-1000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA2114096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com