MEDICARE: TLC ON SUNSET, CORP

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	251E00000X	Home Health Agency	299992951	FL

General Provider Information

NPI Number	:	1790013365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLC ON SUNSET, CORP

Provider Business Mailing Address
First Line	:	973 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3705
Country	:	US
Telephone Number	:	786-360-5732
Fax Number	:

Provider Business Practice Location Address
First Line	:	973 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3705
Country	:	US
Telephone Number	:	786-360-5732
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARIA BONET
Credential	:
Telephone Number	:	786-360-5732

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	11/19/2009

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Directions to “TLC ON SUNSET, CORP ” Practice Location

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