MEDICARE: GEROCARE CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0805X	Geriatric Psychiatry Physician	ME 105037	FL

General Provider Information

NPI Number	:	1083928527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEROCARE CONSULTING LLC

Provider Business Mailing Address
First Line	:	17332 GARDEN HEATH CT
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-8089
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17332 GARDEN HEATH CT
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-8089
Country	:	US
Telephone Number	:	813-412-3421
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER /OWNER
Name	:	DR. INYENE E UMOREN
Credential	:	M.D.
Telephone Number	:	727-286-7645

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	11/02/2010

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