| Tlc Medical Llc | |
|
5106 N Armenia Ave Suite 1 Tampa FL 33603-1433 | |
| (813) 874-1852 | |
| Not Available |
| Full Name | Tlc Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5106 N Armenia Ave, Tampa, Florida |
| Authorized Official Name and Position | Charles David Talakkottur (OWNER) |
| Authorized Official Contact | 8138741852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Medical Llc 5106 N Armenia Ave Suite 1 Tampa FL 33603-1433 Ph: (813) 874-1852 | Tlc Medical Llc 5106 N Armenia Ave Suite 1 Tampa FL 33603-1433 Ph: (813) 874-1852 |
| NPI Number | 1750535811 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 01/09/2012 |
| Medicare PECOS PAC ID | 5890850713 |
|---|---|
| Medicare Enrollment ID | O20090210000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750535811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME100711 (Florida) | Primary |
| Provider Name | Charles D Talakkottur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598949034 PECOS PAC ID: 5092892281 Enrollment ID: I20080412000047 |
| Provider Name | Laura M Talakkottur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275787681 PECOS PAC ID: 1456512896 Enrollment ID: I20120412000198 |
| Provider Name | Sara Elizabeth Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003425232 PECOS PAC ID: 1850718750 Enrollment ID: I20200824001607 |
| Provider Name | John William Ashley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528694882 PECOS PAC ID: 8921427105 Enrollment ID: I20201008000371 |
| Provider Name | Mereena Thayil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093318453 PECOS PAC ID: 2466841101 Enrollment ID: I20220426002705 |
| Provider Name | Stephanie Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801524384 PECOS PAC ID: 9335519354 Enrollment ID: I20230106001952 |
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