Provider Demographics
NPI:1659822757
Name:TELEMEDICINE PROVIDER NETWORK, LLC
Entity Type:Organization
Organization Name:TELEMEDICINE PROVIDER NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:L
Authorized Official - Last Name:TROSPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-859-5205
Mailing Address - Street 1:220 NE 38TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1237
Mailing Address - Country:US
Mailing Address - Phone:561-859-5205
Mailing Address - Fax:888-803-4944
Practice Address - Street 1:220 NE 38TH ST APT 12
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-1237
Practice Address - Country:US
Practice Address - Phone:561-859-5205
Practice Address - Fax:888-803-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL16000192537332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies