MEDICARE: TLC REHAB LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

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	:	1912081142
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	:	352-382-7214

Provider Business Practice Location Address
First Line	:	6778 W GULF TO LAKE HWY
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-9348
Country	:	US
Telephone Number	:	527-956-2253
Fax Number	:	352-795-6065

Authorized Official
Title or Position	:	PRESIDENT OF OUTPATIENT REHABILITAT
Name	:	MRS. DAPHNE SCOTT
Credential	:	PT
Telephone Number	:	405-900-4729

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	03/17/2022

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Directions to “TLC REHAB LLC ” Practice Location

Language	Start Address	Practice Location

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