Healthcare Provider Details

I. General information

NPI: 1073983185
Provider Name (Legal Business Name): ASORAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 TAVISTOCK LAKES BLVD SUITE 400
ORLANDO FL
32827-7589
US

IV. Provider business mailing address

PO BOX 111
LOUGHMAN FL
33858-0111
US

V. Phone/Fax

Practice location:
  • Phone: 888-819-2088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number234141
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number234141
License Number StateFL

VIII. Authorized Official

Name: MRS. KAREN LAROSA PRYCE BENTHAM
Title or Position: CEO
Credential:
Phone: 888-819-2088