MEDICARE: TOTAL CARE MEDICAL SERVICE INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	2162	FL

General Provider Information

NPI Number	:	1760441331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL CARE MEDICAL SERVICE INC.

Provider Business Mailing Address
First Line	:	PO BOX 57731
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32241-7731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8727 PHILIPS HWY
Second Line	:	SUITE # 410
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-1229
Country	:	US
Telephone Number	:	904-730-7285
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MARIA TERESA MONTELONGO
Credential	:
Telephone Number	:	904-730-7285

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	03/25/2013

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