MEDICARE: TLC REHAB, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1982053328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLC REHAB, INC.

Provider Business Mailing Address
First Line	:	PO BOX 741708
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-1708
Country	:	US
Telephone Number	:	352-382-7214
Fax Number	:	352-382-7781

Provider Business Practice Location Address
First Line	:	1537 NE CEDAR ST
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4808
Country	:	US
Telephone Number	:	772-332-1000
Fax Number	:	352-382-7781

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MRS. DREAMA M WALDROP
Credential	:	PT
Telephone Number	:	352-382-7214

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	01/09/2020

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Directions to “TLC REHAB, INC. ” Practice Location

Language	Start Address	Practice Location

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