Healthcare Provider Details

I. General information

NPI: 1184136145
Provider Name (Legal Business Name): INFINITE SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 N GRANDVIEW ST
MOUNT DORA FL
32757-3811
US

IV. Provider business mailing address

17 E MAGNOLIA AVE STE 3-B
EUSTIS FL
32726-3472
US

V. Phone/Fax

Practice location:
  • Phone: 407-986-7557
  • Fax: 352-504-4354
Mailing address:
  • Phone: 407-986-7557
  • Fax: 352-769-4074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number23940
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number23940
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number23940
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEPORSHIA ARVETTA BLACKMON
Title or Position: ADMINISTRATOR
Credential:
Phone: 407-986-7557