Healthcare Provider Details

I. General information

NPI: 1194501916
Provider Name (Legal Business Name): ORANGE COUNTY PERSONAL CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S ORANGE AVE STE 104-1109
ORLANDO FL
32801-3445
US

IV. Provider business mailing address

255 S ORANGE AVE STE 104-1109
ORLANDO FL
32801-3445
US

V. Phone/Fax

Practice location:
  • Phone: 407-974-3424
  • Fax: 833-517-0170
Mailing address:
  • Phone: 407-974-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ANTOINETTE MITCHELL
Title or Position: OWNER
Credential:
Phone: 407-974-3424