Healthcare Provider Details

I. General information

NPI: 1952131344
Provider Name (Legal Business Name): CARE CONNECT MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ARRENDONDA DR
DELTONA FL
32738-2292
US

IV. Provider business mailing address

PO BOX 950310
LAKE MARY FL
32795-0310
US

V. Phone/Fax

Practice location:
  • Phone: 407-529-5341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. KEVON TEMPLE
Title or Position: OWNER
Credential:
Phone: 407-529-5341