MEDICARE: TOTAL CARE CENTER, 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1487921672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	610 NE 12TH AVE APT 401
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-3654
Country	:	US
Telephone Number	:	772-631-2896
Fax Number	:	954-505-4491

Provider Business Practice Location Address
First Line	:	610 NE 12TH AVE APT 401
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-3654
Country	:	US
Telephone Number	:	727-631-2896
Fax Number	:	772-264-8106

Authorized Official
Title or Position	:	OWNER
Name	:	NATALYA KLYUCHKO
Credential	:	AP; RN
Telephone Number	:	772-631-2896

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	10/27/2025

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