Provider Demographics
NPI:1831173681
Name:THERAPEUTIC SERVICES OF AMERICA INC
Entity type:Organization
Organization Name:THERAPEUTIC SERVICES OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:O
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-896-6047
Mailing Address - Street 1:2454 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5059
Mailing Address - Country:US
Mailing Address - Phone:407-896-6047
Mailing Address - Fax:407-895-1261
Practice Address - Street 1:2454 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5059
Practice Address - Country:US
Practice Address - Phone:407-896-6047
Practice Address - Fax:407-895-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH12835333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0696710001Medicare ID - Type Unspecified