Provider Demographics
NPI:1760895734
Name:TMS OF ORLANDO
Entity Type:Organization
Organization Name:TMS OF ORLANDO
Other - Org Name:ESPERANZA BEHAVIORAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDESVINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS-ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-226-3733
Mailing Address - Street 1:7350 FUTURES DR
Mailing Address - Street 2:SUITE #16
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9083
Mailing Address - Country:US
Mailing Address - Phone:407-226-3733
Mailing Address - Fax:407-226-3734
Practice Address - Street 1:7350 FUTURES DR
Practice Address - Street 2:SUITE #16
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9083
Practice Address - Country:US
Practice Address - Phone:407-226-3733
Practice Address - Fax:407-226-3734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL008905800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008905800Medicaid