Healthcare Provider Details

I. General information

NPI: 1316058217
Provider Name (Legal Business Name): VAXCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N MAGNOLIA AVE STE 700
ORLANDO FL
32803-3264
US

IV. Provider business mailing address

800 N MAGNOLIA AVE STE 700
ORLANDO FL
32803-3264
US

V. Phone/Fax

Practice location:
  • Phone: 888-829-8550
  • Fax: 855-418-9149
Mailing address:
  • Phone: 888-829-8550
  • Fax: 855-418-9149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MR. BRETT KENEFICK
Title or Position: PRESIDENT
Credential:
Phone: 888-829-8550