| Tlc Medical Group,inc. | |
|
537 Nw Lake Whitney Pl Unit 103-106 Port Saint Lucie FL 34986-1620 | |
| (772) 877-8578 | |
| Not Available |
| Full Name | Tlc Medical Group,inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 537 Nw Lake Whitney Pl, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Anthony B Lewis (PRESIDENT) |
| Authorized Official Contact | 7725289074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Medical Group,inc. 1391 Nw Saint Lucie West Blvd #216 Port Saint Lucie FL 34986-2196 Ph: () - | Tlc Medical Group,inc. 537 Nw Lake Whitney Pl Unit 103-106 Port Saint Lucie FL 34986-1620 Ph: (772) 877-8578 |
| NPI Number | 1972048536 |
|---|---|
| Provider Enumeration Date | 01/05/2017 |
| Last Update Date | 01/11/2021 |
| Medicare PECOS PAC ID | 5597041657 |
|---|---|
| Medicare Enrollment ID | O20170404002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972048536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Anthony B Lewis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396776522 PECOS PAC ID: 8820986714 Enrollment ID: I20040311000968 |
| Provider Name | Jacqueline Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548856230 PECOS PAC ID: 4385013291 Enrollment ID: I20221216000518 |
| Provider Name | Loudie Valme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992443931 PECOS PAC ID: 6800255399 Enrollment ID: I20230630001164 |
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