MEDICARE: TRANS AMERICA LIVE SOLUTIONS,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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1952559957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANS AMERICA LIVE SOLUTIONS,INC.

Provider Business Mailing Address
First Line	:	6742 FOREST HILL BLVD
Second Line	:	#215
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413
Country	:	US
Telephone Number	:	786-506-5481
Fax Number	:

Provider Business Practice Location Address
First Line	:	6742 FOREST HILL BLVD
Second Line	:	#215
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413
Country	:	US
Telephone Number	:	786-506-5481
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JUAN CARRALERO
Credential	:
Telephone Number	:	786-506-5481

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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