Healthcare Provider Details

I. General information

NPI: 1487223442
Provider Name (Legal Business Name): PARADISE CARE OF ORLANDO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N SEMORAN BLVD STE 136
ORLANDO FL
32807-3558
US

IV. Provider business mailing address

1700 N SEMORAN BLVD STE 136
ORLANDO FL
32807-3558
US

V. Phone/Fax

Practice location:
  • Phone: 407-903-6164
  • Fax: 407-903-6195
Mailing address:
  • Phone: 407-903-6164
  • Fax: 407-903-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUNIOR S. CARRASCAL
Title or Position: PRESIDENT
Credential:
Phone: 407-421-8322