MEDICARE: TCORP INC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1598980690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TCORP INC

Provider Business Mailing Address
First Line	:	2013 E JEFFERSON STREET
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803
Country	:	US
Telephone Number	:	321-206-6308
Fax Number	:	407-574-5715

Provider Business Practice Location Address
First Line	:	2013 E JEFFERSON STREET
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803
Country	:	US
Telephone Number	:	321-206-6308
Fax Number	:	407-574-5715

Authorized Official
Title or Position	:	PRESIDENT ADMINISTRATOR
Name	:	MR. TIMOTHY EDWARD DRABICK
Credential	:
Telephone Number	:	321-206-6308

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	08/22/2020

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