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General NPI Number Information
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NPI Number | 1790283695
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Entity Type | Organization
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Legal Business Name | T.P.D.S., INC.
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 3001 ALOMA AVE
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City | WINTER PARK
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State | FL
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Zip | 32792-3752
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Country | US
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Telephone | 407-567-7011
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Fax | 407-567-7011
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Provider Business Mailing Address
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Address Line | 7228 CLARCONA OCOEE RD UNIT 124
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City | CLARCONA
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State | FL
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Zip | 32710-2001
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Country | US
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Telephone | 321-437-3715
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Fax | 407-567-7011
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Authorized Official
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Title or Position | MEDICAL PROVIDER
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Name | LATONYA SMITH
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Credential | MS
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Telephone | 321-437-3715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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