MEDICARE: TOWN AND COUNTRY MEDICAL GROUP, 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	261Q00000X	Clinic/Center	ME0035878	FL

General Provider Information

NPI Number	:	1699940718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN AND COUNTRY MEDICAL GROUP, LLC.

Provider Business Mailing Address
First Line	:	5901 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-888-8215
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-888-8215
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ANTONIO CALVO
Credential	:
Telephone Number	:	813-888-8215

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	03/14/2025

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