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General NPI Number Information
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NPI Number | 1669265005
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Entity Type | Organization
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Legal Business Name | TLC TELECARE LLC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 5110 N 40TH ST
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City | TAMPA
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State | FL
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Zip | 33610-5204
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Country | US
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Telephone | 813-800-6337
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Fax |
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Provider Business Mailing Address
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Address Line | 5110 N 40TH ST
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City | TAMPA
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State | FL
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Zip | 33610-5204
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Country | US
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Telephone | 813-800-6337
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING PERSONNEL
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Name | JAMECA JORDEN
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Credential |
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Telephone | 813-359-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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