Provider Demographics
NPI:1083622161
Name:TLC MASSAGE, INC
Entity Type:Organization
Organization Name:TLC MASSAGE, INC
Other - Org Name:TENDER LOVING CARE MASSAGE & SKIN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSE MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:RENDON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:561-965-5500
Mailing Address - Street 1:2774 POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-2153
Mailing Address - Country:US
Mailing Address - Phone:561-439-3262
Mailing Address - Fax:
Practice Address - Street 1:2072 S MILITARY TRL
Practice Address - Street 2:SUITE 7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-6419
Practice Address - Country:US
Practice Address - Phone:561-965-5500
Practice Address - Fax:561-965-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0012117174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM11805OtherLIC ESTABLISMENT