Healthcare Provider Details

I. General information

NPI: 1225293103
Provider Name (Legal Business Name): CARMITA'S HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CONWAY GARDENS RD
ORLANDO FL
32806-6601
US

IV. Provider business mailing address

2700 CONWAY GARDENS RD
ORLANDO FL
32806-6601
US

V. Phone/Fax

Practice location:
  • Phone: 407-432-6785
  • Fax: 407-897-7452
Mailing address:
  • Phone: 407-432-6785
  • Fax: 407-897-7452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL11236
License Number StateFL

VIII. Authorized Official

Name: JESUS PRIETO
Title or Position: PRESIDENT
Credential: ASSISTING LIVING
Phone: 407-432-6785