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General NPI Number Information
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NPI Number | 1801582127
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Entity Type | Organization
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Legal Business Name | MY CARIBBEAN DOCTOR, P.C.
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 120 N HIGHWAY 52 STE B
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3996
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Country | US
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Telephone | 803-814-5779
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Fax |
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Provider Business Mailing Address
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Address Line | 10070 DORCHESTER RD UNIT 50301
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City | SUMMERVILLE
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State | SC
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Zip | 29485-2530
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Country | US
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Telephone | 803-814-5779
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. KELENNE TUITT
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Credential | DO
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Telephone | 803-814-5779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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