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Organization
T.B.C. VENTURES LLC
Active
Organization
T.B.C. VENTURES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CORNISH PT (MANAGER)
(727) 251-8903
Entity
Organization
Contact information
Practice address
1501 N BELCHER RD STE 166, CLEARWATER, FL 33765-1339
(727) 251-8903
(727) 216-6999
Mailing address
493 LAKESIDE PL, LARGO, FL 33771-1429
(727) 251-8903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT19198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014745200
—
FL
Enumeration date
04/28/2017
Last updated
12/20/2019
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