Healthcare Provider Details

I. General information

NPI: 1316883531
Provider Name (Legal Business Name): ROYAL CARE OF CENTRAL FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12623 SW SR 45
ARCHER FL
32618-5682
US

IV. Provider business mailing address

12623 SW SR 45
ARCHER FL
32618-5682
US

V. Phone/Fax

Practice location:
  • Phone: 352-225-0141
  • Fax:
Mailing address:
  • Phone: 352-225-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: EBONY LASSITER
Title or Position: OWNER
Credential:
Phone: 352-225-0141