Provider Demographics
NPI:1518920198
Name:LTC PROFESSIONAL CONSULTANTS, INC.
Entity Type:Organization
Organization Name:LTC PROFESSIONAL CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-668-4540
Mailing Address - Street 1:7400 SW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4497
Mailing Address - Country:US
Mailing Address - Phone:305-668-4540
Mailing Address - Fax:305-668-4541
Practice Address - Street 1:7400 SW 48TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4497
Practice Address - Country:US
Practice Address - Phone:305-668-4540
Practice Address - Fax:305-668-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20656096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-8042Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER #
FL108042Medicare Oscar/Certification