Provider Demographics
NPI:1801582127
Name:MY CARIBBEAN DOCTOR, P.C.
Entity type:Organization
Organization Name:MY CARIBBEAN DOCTOR, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUITT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:803-814-5779
Mailing Address - Street 1:10070 DORCHESTER RD UNIT 50301
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-2530
Mailing Address - Country:US
Mailing Address - Phone:803-814-5779
Mailing Address - Fax:
Practice Address - Street 1:120 N HIGHWAY 52 STE B
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3996
Practice Address - Country:US
Practice Address - Phone:803-814-5779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty