Provider Demographics
NPI:1689337156
Name:TMS OF ORLANDO CORP.
Entity Type:Organization
Organization Name:TMS OF ORLANDO CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-226-3733
Mailing Address - Street 1:7350 FUTURES DR STE 16
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9084
Mailing Address - Country:US
Mailing Address - Phone:407-226-3733
Mailing Address - Fax:407-226-3734
Practice Address - Street 1:306 S 10TH ST STE 340
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-5602
Practice Address - Country:US
Practice Address - Phone:407-226-3733
Practice Address - Fax:407-226-3734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TMS OF ORLANDO CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0089058Medicaid