Provider Demographics
NPI:1366731523
Name:TLC HOME CARE SERVICES OF CENTRAL FL INC
Entity type:Organization
Organization Name:TLC HOME CARE SERVICES OF CENTRAL FL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAZMIN
Authorized Official - Middle Name:FLOR
Authorized Official - Last Name:SERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-618-9949
Mailing Address - Street 1:238 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707
Mailing Address - Country:US
Mailing Address - Phone:321-972-4067
Mailing Address - Fax:407-386-3056
Practice Address - Street 1:101 TIMBERLACHEN CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6124
Practice Address - Country:US
Practice Address - Phone:407-878-1296
Practice Address - Fax:407-386-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993783251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0099005600Medicaid