MEDICARE: GREYSTONE HOME HEALTHCARE OF GREATER 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	251E00000X	Home Health Agency	299992080	FL

General Provider Information

NPI Number	:	1891172771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREYSTONE HOME HEALTHCARE OF GREATER ORLANDO LLC

Provider Business Mailing Address
First Line	:	12701 S JOHN YOUNG PKWY STE 219
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-3423
Country	:	US
Telephone Number	:	407-855-5728
Fax Number	:	407-855-5730

Provider Business Practice Location Address
First Line	:	12701 S JOHN YOUNG PKWY
Second Line	:	#219, #220
City	:	ORLANDO
State	:	FL
Zip	:	32837-3420
Country	:	US
Telephone Number	:	407-855-5728
Fax Number	:	407-855-5730

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JACQUELINE F. PRICE
Credential	:
Telephone Number	:	813-635-9500

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	03/16/2021

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