Provider Demographics
NPI:1922575281
Name:T.L.C. NURSING REGISTRY
Entity Type:Organization
Organization Name:T.L.C. NURSING REGISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-964-5500
Mailing Address - Street 1:2514 HOLLYWOOD BLVD STE 508
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6635
Mailing Address - Country:US
Mailing Address - Phone:954-980-8004
Mailing Address - Fax:954-964-5511
Practice Address - Street 1:20900 NE 30TH AVE FL 8
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2165
Practice Address - Country:US
Practice Address - Phone:888-817-6217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T.L.C. NURSING REGISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-25
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101541000Medicaid