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NPI Code Detail

MEDICARE: TLC TELECARE LLC

MEDICARE: TLC TELECARE 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
1363LF0000XFamily Nurse Practitioner

Other Identifiers

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

General Provider Information

NPI Number : 1669265005
Entity Type Code : Organization
Provider Name (Legal Business Name) : TLC TELECARE LLC
Provider Business Mailing Address
First Line : 5110 N 40TH ST
Second Line :
City : TAMPA
State : FL
Zip : 33610-5204
Country : US
Telephone Number : 813-800-6337
Fax Number :
Provider Business Practice Location Address
First Line : 5110 N 40TH ST
Second Line :
City : TAMPA
State : FL
Zip : 33610-5204
Country : US
Telephone Number : 813-800-6337
Fax Number :
Authorized Official
Title or Position : CREDENTIALING PERSONNEL
Name : JAMECA JORDEN
Credential :
Telephone Number : 813-359-9130
Provider Enumeration Date : 05/28/2025
Last Update Date : 05/28/2025

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Directions to “TLC TELECARE LLC ” Practice Location

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