MEDICARE: THERAPEUTIC MANAGEMENT SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1174941843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC MANAGEMENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	7808 BROCKWOOD CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-7874
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7808 BROCKWOOD CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-7874
Country	:	US
Telephone Number	:	407-580-2868
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LAQUANDA RENEE RICHARDSON
Credential	:
Telephone Number	:	407-580-2868

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	03/31/2014

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