Provider Demographics
NPI:1003914441
Name:THE HEALTHCARING CLINIC OF FLORIDA, LLC
Entity Type:Organization
Organization Name:THE HEALTHCARING CLINIC OF FLORIDA, LLC
Other - Org Name:THE LITTLE CLINIC OF FLORIDA LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSCALZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-907-2661
Mailing Address - Street 1:P.O. BOX 681765
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1765
Mailing Address - Country:US
Mailing Address - Phone:866-862-7276
Mailing Address - Fax:
Practice Address - Street 1:2621 ENTERPRISE RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763
Practice Address - Country:US
Practice Address - Phone:386-456-0289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTHCARING COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAE795Medicare PIN