MEDICARE: T.L.C. NURSING REGISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	251J00000X	Nursing Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124764428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T.L.C. NURSING REGISTRY

Provider Business Mailing Address
First Line	:	2514 HOLLYWOOD BLVD STE 508
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6635
Country	:	US
Telephone Number	:	954-964-5500
Fax Number	:	954-964-5511

Provider Business Practice Location Address
First Line	:	12553 NEW BRITTANY BLVD
Second Line	:	SUITE 3210
City	:	FORT MYERS
State	:	FL
Zip	:	33907
Country	:	US
Telephone Number	:	954-964-5500
Fax Number	:	954-964-5511

Authorized Official
Title or Position	:	OWNER
Name	:	FARID SAHARI
Credential	:
Telephone Number	:	954-964-5500

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	02/16/2026

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