Provider Demographics
NPI:1003339680
Name:MEDICAL TRANSITIONAL CARE SERVICES, PLLC
Entity Type:Organization
Organization Name:MEDICAL TRANSITIONAL CARE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOMASSINO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:917-254-1294
Mailing Address - Street 1:14176 BLACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8235
Mailing Address - Country:US
Mailing Address - Phone:917-254-1294
Mailing Address - Fax:561-293-8260
Practice Address - Street 1:14176 BLACKBERRY DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8235
Practice Address - Country:US
Practice Address - Phone:917-254-1294
Practice Address - Fax:917-254-1294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty