MEDICARE: TLC COMPANIONS OF TRINITY

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	251E00000X	Home Health Agency	235048	FL

General Provider Information

NPI Number	:	1689175010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLC COMPANIONS OF TRINITY

Provider Business Mailing Address
First Line	:	1805 CYPRESS BROOK DR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-4417
Country	:	US
Telephone Number	:	727-312-4429
Fax Number	:	727-312-3745

Provider Business Practice Location Address
First Line	:	1805 CYPRESS BROOK DR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-4417
Country	:	US
Telephone Number	:	727-312-4429
Fax Number	:	727-312-3745

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DAWN ROBINSON
Credential	:
Telephone Number	:	727-312-4429

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/21/2018

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