MEDICARE: TUTTLE HEALTH, LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	14564	FL
2	261Q00000X	Clinic/Center	12257	FL

General Provider Information

NPI Number	:	1205341930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUTTLE HEALTH, LLC

Provider Business Mailing Address
First Line	:	2595 TAMPA RD STE H
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3130
Country	:	US
Telephone Number	:	727-509-3760
Fax Number	:

Provider Business Practice Location Address
First Line	:	2595 TAMPA RD STE H
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3130
Country	:	US
Telephone Number	:	678-334-1504
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. DANIEL MARK TUTTLE
Credential	:	DC
Telephone Number	:	678-334-1504

Provider Enumeration Date	:	12/04/2017
Last Update Date	:	01/22/2018

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