Healthcare Provider Details

I. General information

NPI: 1306081831
Provider Name (Legal Business Name): MEDICOR HOMECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2008
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 850001
ORLANDO FL
32885-0001
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-8965
  • Fax:
Mailing address:
  • Phone: 800-250-4468
  • Fax: 866-930-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number326710
License Number StateFL

VIII. Authorized Official

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