=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689767337
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENDER LOVING CARE MEDICAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 05/13/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | AVENUE RAFAEL CORDERO CALLE TROCHE OF L01 ANTIGUO HOSPITAL MUNICIPAL
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-648-0127
-----------------------------------------------------
Fax | 787-653-6089
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8034
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00726-8034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-648-0127
-----------------------------------------------------
Fax | 787-653-6089
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR/ OFFICER
-----------------------------------------------------
Name | MRS. ROCIO S MADRINAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-648-0127
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------