MEDICARE: TLC REHAB, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	225X00000X	Occupational Therapist	FL
2	225XH1200X	Hand Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	225100000X	Physical Therapist	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548237118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLC REHAB, LLC

Provider Business Mailing Address
First Line	:	PO BOX 741708
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-1708
Country	:	US
Telephone Number	:	352-382-7214
Fax Number	:	352-382-7781

Provider Business Practice Location Address
First Line	:	2679 N FOREST RIDGE BLVD
Second Line	:
City	:	HERNANDO
State	:	FL
Zip	:	34442-5123
Country	:	US
Telephone Number	:	352-746-2371
Fax Number	:	352-746-3729

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MRS. DREAMA M WALDROP
Credential	:	PT
Telephone Number	:	352-382-7214

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	10/18/2021

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Directions to “TLC REHAB, LLC ” Practice Location

Language	Start Address	Practice Location

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