Healthcare Provider Details

I. General information

NPI: 1922367010
Provider Name (Legal Business Name): QUALITY CARE PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 05/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5565 CINDERLANE PKWY 291
ORLANDO FL
32808-4705
US

IV. Provider business mailing address

5565 CINDERLANE PKWY 291
ORLANDO FL
32808-4705
US

V. Phone/Fax

Practice location:
  • Phone: 321-946-3413
  • Fax:
Mailing address:
  • Phone: 321-946-3413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DEANNA KIMBELL
Title or Position: FOUNDER/CEO
Credential:
Phone: 321-946-3413