Provider Demographics
NPI:1710381223
Name:DOCTORTODAY TLC,LLC
Entity Type:Organization
Organization Name:DOCTORTODAY TLC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEETENDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ISSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-858-8000
Mailing Address - Street 1:3810 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1105
Mailing Address - Country:US
Mailing Address - Phone:863-619-5100
Mailing Address - Fax:863-619-5102
Practice Address - Street 1:4435 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-0402
Practice Address - Country:US
Practice Address - Phone:863-858-8000
Practice Address - Fax:863-858-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME863433336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy