Provider Demographics
NPI:1609122092
Name:TACTICAL MANAGEMENT INC.
Entity Type:Organization
Organization Name:TACTICAL MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-585-9953
Mailing Address - Street 1:2699 LEE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1753
Mailing Address - Country:US
Mailing Address - Phone:866-585-9953
Mailing Address - Fax:
Practice Address - Street 1:2699 LEE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1753
Practice Address - Country:US
Practice Address - Phone:866-585-9953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage