Healthcare Provider Details

I. General information

NPI: 1174975742
Provider Name (Legal Business Name): HANDS ON CENTRAL FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 07/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S ORANGE BLOSSOM TRL STE 261
ORLANDO FL
32805-3197
US

IV. Provider business mailing address

750 S ORANGE BLOSSOM TRL STE 261
ORLANDO FL
32805-3197
US

V. Phone/Fax

Practice location:
  • Phone: 407-270-6685
  • Fax:
Mailing address:
  • Phone: 407-270-6685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEIDRA CHANTEL OLIVER
Title or Position: TCM
Credential: MS
Phone: 407-270-6685