MEDICARE: CARETENDERS VISITING SERVICES OF ORLANDO, 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1427582048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARETENDERS VISITING SERVICES OF ORLANDO, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	474 S NORTHLAKE BLVD
Second Line	:	SUITE 1020
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5245
Country	:	US
Telephone Number	:	321-214-6118
Fax Number	:	321-207-0032

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	MR. NICHOLAS GACHASSIN III
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	04/20/2021

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