Healthcare Provider Details

I. General information

NPI: 1144751512
Provider Name (Legal Business Name): MINDER HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 S RIO GRANDE AVE SUITE 202B
ORLANDO FL
32809-4650
US

IV. Provider business mailing address

6000 S. RIO GRANDE AVE, STE 202B
ORLANDO FL
32809-4650
US

V. Phone/Fax

Practice location:
  • Phone: 407-346-6364
  • Fax:
Mailing address:
  • Phone: 407-809-5111
  • Fax: 407-809-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number299994678
License Number StateFL

VIII. Authorized Official

Name: GARY DORLEUS
Title or Position: OWNER
Credential:
Phone: 407-809-5111