Provider Demographics
NPI:1669400347
Name:DOCTOR TODAY TLC, LLC
Entity type:Organization
Organization Name:DOCTOR TODAY TLC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-619-5100
Mailing Address - Street 1:3810 S FLORIDA AVE
Mailing Address - Street 2:SUIT# A1
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1105
Mailing Address - Country:US
Mailing Address - Phone:863-619-5100
Mailing Address - Fax:863-619-5102
Practice Address - Street 1:3810 S FLORIDA AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1129
Practice Address - Country:US
Practice Address - Phone:863-858-8000
Practice Address - Fax:877-531-4854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
FLME86343302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH29656Medicare UPIN
FL193556Medicare ID - Type Unspecified