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General NPI Number Information
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NPI Number | 1134446016
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Entity Type | Organization
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Legal Business Name | TOTAL CARE DIABETES, LLC
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 3720 CURTIS BLVD SUITE 102
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City | COCOA
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State | FL
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Zip | 32927-3961
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Country | US
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Telephone | 321-305-4978
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 CURTIS BLVD SUITE 102
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City | COCOA
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State | FL
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Zip | 32927-3961
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Country | US
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Telephone | 321-305-4978
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SUSAN T VEAUDRY
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Credential |
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Telephone | 321-305-4978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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