Healthcare Provider Details

I. General information

NPI: 1962700500
Provider Name (Legal Business Name): MEDICOR HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8810 COMMODITY CIR STE 31
ORLANDO FL
32819-9066
US

IV. Provider business mailing address

PO BOX 415000
NASHVILLE TN
37241-5000
US

V. Phone/Fax

Practice location:
  • Phone: 800-250-4468
  • Fax: 866-930-8001
Mailing address:
  • Phone: 800-250-4468
  • Fax: 866-930-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MANUEL DELGADO JR.
Title or Position: PRESIDENT
Credential:
Phone: 813-930-8000