Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1639715121 Individual Practitioner Female Practitioner

Lillie Tidwell

Homemaker • Winter Haven, FL

Professional Overview & Biography Verified Profile Summary

Lillie Tidwell is a registered healthcare professional specializing in Homemaker in Winter Haven, FL. Practice services are available at 2332 ISLE ROYALE CT SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2332 Isle Royale Ct Se

Winter Haven, FL 338804325

Telephone 8635956212
Associated Practice Facility / Clinic
🏢 Kesha Health Care Service,llc Facility NPI 1700176732

Specialty Benchmarks & Practice Insights

Comparative analytics for Homemaker in Winter Haven, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
15 Specialists

Practicing in Winter Haven, FL (774 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-11-03
Homemaker Primary Specialty

NUCC Taxonomy Code: 376J00000X

State License FL 104129000

An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
104851900 (FL)
Medicaid State Provider ID
104129000 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Nakesha Young

Community Health Worker

NPI 1427464163

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
👤
Provider Name / Credentials Updated November 03, 2022

Recorded as LILLIE TIDWELL

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 03, 2022

Homemaker (License #104129000 in FL)

📍
Updated Practice Location August 19, 2022

Registered at 2332 ISLE ROYALE CT SE, WINTER HAVEN, FL 338804325 (Tel: 8635956212)

📍
Updated Business Mailing Address August 19, 2022

Registered at 2332 ISLE ROYALE CT SE, WINTER HAVEN, FL 338804325 (Tel: 8635956212)

NPI Profile Active November 20, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location November 20, 2019

Registered at 440 SAVANNA POINTE ST, WINTER HAVEN, FL 338844216 (Tel: 8635956212)

📍
Updated Business Mailing Address November 20, 2019

Registered at 440 SAVANNA POINTE ST, WINTER HAVEN, FL 338844216 (Tel: 8635956212)

👤
Provider Name / Credentials Updated November 20, 2019

Recorded as LILIE TIDWELL

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2019

Clinic/Center

🟢
Initial NPI Registration & Enumeration November 20, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639715121
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 20, 2019
Last Update: November 03, 2022
Sole Proprietor: Yes

Mailing Address

2332 Isle Royale Ct Se

Winter Haven, FL 338804325

Phone: 8635956212

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.