Provider Demographics
NPI:1124764428
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:954-964-5500
Mailing Address - Fax:954-964-5511
Practice Address - Street 1:9990 COCONUT ROAD
Practice Address - Street 2:SUITE 318
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135
Practice Address - Country:US
Practice Address - Phone:954-964-5500
Practice Address - Fax:954-964-5511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC NURSING REGISTRY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-09
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024540600Medicaid
FL117430800Medicaid