Tidwell, Lillie

Tidwell, Lillie is an sole proprietor health care provider with primary practice located at 2332 Isle Royale Ct Se , Winter Haven FL 33880-4325. She recently has only one registered license in Nursing Service Related Providers / Homemaker, which is considered as her primary health care specialty. Tidwell, Lillie can be contacted via phone (863) 595-6212.

Contact Information

Primary practice address
2332 Isle Royale Ct Se Winter Haven FL 33880-4325
Phone: (863) 595-6212
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Homemaker 376J00000X 104129000 Florida

Profile Details

NPI number 1639715121
LBN Legal business name Tidwell, Lillie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2019
Last updated Nov 3rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639715121 NPPES
Florida MEDICAID 104851900
Florida MEDICAID 104129000

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