Healthcare Provider Details

I. General information

NPI: 1245165182
Provider Name (Legal Business Name): CLEANSWEEP COLLECTIVE LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 36TH ST
ORLANDO FL
32839-8806
US

IV. Provider business mailing address

1317 EDGEWATER DR # 7448
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 407-212-7057
  • Fax:
Mailing address:
  • Phone: 407-212-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JEQUAN BURTON
Title or Position: CEO
Credential:
Phone: 407-212-7057