Provider Demographics
NPI:1861689796
Name:DOCTOR TODAY TLC, LLC
Entity Type:Organization
Organization Name:DOCTOR TODAY TLC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-682-8124
Mailing Address - Street 1:2929 LAKELAND HIGHLANDS RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4371
Mailing Address - Country:US
Mailing Address - Phone:863-682-8124
Mailing Address - Fax:863-682-8125
Practice Address - Street 1:2929 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4371
Practice Address - Country:US
Practice Address - Phone:863-682-8124
Practice Address - Fax:863-682-8125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86633174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD8256OtherMEDICARE RAILROAD
FLH08884Medicare UPIN
FLD8256OtherMEDICARE RAILROAD
FLK4399Medicare PIN