Healthcare Provider Details

I. General information

NPI: 1376111930
Provider Name (Legal Business Name): KM HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4861 S ORANGE AVE STE 4A
ORLANDO FL
32806-6949
US

IV. Provider business mailing address

4861 S ORANGE AVE STE 4A
ORLANDO FL
32806-6949
US

V. Phone/Fax

Practice location:
  • Phone: 877-400-5648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: ANA V EXPOSITO
Title or Position: CEO
Credential:
Phone: 786-310-5591