1396841292 NPI number — CARETENDERS VISITING SERVICES OF ORLANDO, LLC

Table of content: (NPI 1396841292)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396841292 NPI number — CARETENDERS VISITING SERVICES OF ORLANDO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARETENDERS VISITING SERVICES OF ORLANDO, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CARETENDERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396841292
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9510 ORMSBY STATION RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40223-4081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-891-1000
Provider Business Mailing Address Fax Number:
502-891-8067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
474 S NORTHLAKE BLVD
Provider Second Line Business Practice Location Address:
SUITE 1020
Provider Business Practice Location Address City Name:
ALTAMONTE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32701-5245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-661-1963
Provider Business Practice Location Address Fax Number:
407-875-0286
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LYLES
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
TODD
Authorized Official Title or Position:
SR. V.P., ADMINISTRATION
Authorized Official Telephone Number:
502-891-1044

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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