Provider Demographics
NPI:1851668552
Name:TNC MEDICAL INC
Entity Type:Organization
Organization Name:TNC MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-886-9597
Mailing Address - Street 1:8316 HANLEY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2284
Mailing Address - Country:US
Mailing Address - Phone:813-886-9597
Mailing Address - Fax:813-882-3388
Practice Address - Street 1:8316 HANLEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2284
Practice Address - Country:US
Practice Address - Phone:813-886-9597
Practice Address - Fax:813-882-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0056941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062321100Medicaid
FL09879Medicare PIN
FLB11538Medicare UPIN