MEDICARE: QUALITY MEDICAL CARE SERVICES 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	363LP2300X	Primary Care Nurse Practitioner

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

General Provider Information

NPI Number	:	1427762756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY MEDICAL CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	2604 LINDELL AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-7757
Country	:	US
Telephone Number	:	813-210-2584
Fax Number	:

Provider Business Practice Location Address
First Line	:	10005 N DALE MABRY HWY # 115
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4409
Country	:	US
Telephone Number	:	813-284-8900
Fax Number	:	813-867-4600

Authorized Official
Title or Position	:	OWNER/APRN
Name	:	QUANKELA TILLMAN
Credential	:	APRN
Telephone Number	:	813-284-8900

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	02/02/2026

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