Provider Demographics
NPI:1790013365
Name:TLC ON SUNSET, CORP
Entity Type:Organization
Organization Name:TLC ON SUNSET, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-5732
Mailing Address - Street 1:973 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3705
Mailing Address - Country:US
Mailing Address - Phone:786-360-5732
Mailing Address - Fax:
Practice Address - Street 1:973 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3705
Practice Address - Country:US
Practice Address - Phone:786-360-5732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992951251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health