Healthcare Provider Details

I. General information

NPI: 1932897741
Provider Name (Legal Business Name): TSAICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8614 STATE ROAD 70 E STE 101
BRADENTON FL
34202-3710
US

IV. Provider business mailing address

12111 BLUE HILL TRL
BRADENTON FL
34211-3443
US

V. Phone/Fax

Practice location:
  • Phone: 941-779-3334
  • Fax:
Mailing address:
  • Phone: 941-737-8927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID TSAI
Title or Position: MD
Credential: MD
Phone: 941-737-8927