Healthcare Provider Details

I. General information

NPI: 1235683939
Provider Name (Legal Business Name): NEW BEGINNINGS PRIVATE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 INTERNATIONAL PKWY SUITE 100-10
HEATHROW FL
32746-5056
US

IV. Provider business mailing address

160 INTERNATIONAL PKWY SUITE 100-10
HEATHROW FL
32746-5056
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-4700
  • Fax: 407-504-6489
Mailing address:
  • Phone: 407-574-4700
  • Fax: 407-504-6489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number234451
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LUIS OMAR PIZARRO
Title or Position: PRESIDENT
Credential:
Phone: 407-574-4700