Provider Demographics
NPI:1750639084
Name:TOTAL CARE & WELLNESS SERVICES INC
Entity Type:Organization
Organization Name:TOTAL CARE & WELLNESS SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIMASI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:727-643-9632
Mailing Address - Street 1:3870 TAMPA RD STE D
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3120
Mailing Address - Country:US
Mailing Address - Phone:813-336-4949
Mailing Address - Fax:813-336-4944
Practice Address - Street 1:3870 TAMPA RD STE D
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3120
Practice Address - Country:US
Practice Address - Phone:813-336-4949
Practice Address - Fax:813-336-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
21762OtherBCBS
21762OtherBCBS
FLFO7743Medicare UPIN