Provider Demographics
NPI:1669265005
Name:TLC TELECARE LLC
Entity type:Organization
Organization Name:TLC TELECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING PERSONNEL
Authorized Official - Prefix:
Authorized Official - First Name:JAMECA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-359-9130
Mailing Address - Street 1:5110 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-5204
Mailing Address - Country:US
Mailing Address - Phone:813-800-6337
Mailing Address - Fax:
Practice Address - Street 1:5110 N 40TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-5204
Practice Address - Country:US
Practice Address - Phone:813-800-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL126866200Medicaid