Healthcare Provider Details

I. General information

NPI: 1083928527
Provider Name (Legal Business Name): GEROCARE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17332 GARDEN HEATH CT
LAND O LAKES FL
34638-8089
US

IV. Provider business mailing address

17332 GARDEN HEATH CT
LAND O LAKES FL
34638-8089
US

V. Phone/Fax

Practice location:
  • Phone: 813-412-3421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME 105037
License Number StateFL

VIII. Authorized Official

Name: DR. INYENE E UMOREN
Title or Position: MANAGING MEMBER /OWNER
Credential: M.D.
Phone: 727-286-7645