Provider Demographics
NPI:1104372507
Name:TRUE CARE DOCS LLC
Entity Type:Organization
Organization Name:TRUE CARE DOCS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CREDENTIALING
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-527-1055
Mailing Address - Street 1:8613 OLD KINGS RD S
Mailing Address - Street 2:UNIT 303
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4807
Mailing Address - Country:US
Mailing Address - Phone:904-527-1055
Mailing Address - Fax:
Practice Address - Street 1:8613 OLD KINGS RD S
Practice Address - Street 2:UNIT 303
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4807
Practice Address - Country:US
Practice Address - Phone:904-527-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty