NPIMap

Organization Active NPI

Tender Care Medical Services of St. Johns County, Inc.

  • Clinic/Center
  • Palatka, FL
National Provider Identifier
1356905079
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TENDER CARE MEDICAL SERVICES OF ST. JOHNS COUNTY, INC.
Practice address
927 S State Road 19
Palatka, FL 32177-9397
Phone
(386) 336-9028
Fax
(386) 336-9029
NPI assigned
Apr 29, 2019
Organization subpart
Yes
Parent organization
TENDER CARE MEDICAL SERVICES OF ST. JOHNS COUNTY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lori Mazzuco
Title
Billing Specialist
Phone
(352) 683-6831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

927 S State Road 19
Palatka, FL 32177-9397

Mailing address

PO Box 5159
Spring Hill, FL 34611-5159
Phone (352) 683-6831

National Provider Directory

National Provider Directory
Tax ID family
Tender Care Medical Services of St Johns Inc5 organizations share this tax ID, including this one
Part of
Tender Care Medical Services of St Johns Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1356905079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5159",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346115159",
            "telephone_number": "352-683-6831",
            "fax_number": "352-666-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 S STATE ROAD 19",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779397",
            "telephone_number": "386-336-9028",
            "fax_number": "386-336-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER CARE MEDICAL SERVICES OF ST. JOHNS COUNTY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENDER CARE MEDICAL SERVICES OF ST. JOHNS COUNTY, INC.",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "MAZZUCO",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "352-683-6831",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.