Healthcare Provider Details

I. General information

NPI: 1083186605
Provider Name (Legal Business Name): ADELCARE II, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 CONWAY RD STE 5
ORLANDO FL
32812-7316
US

IV. Provider business mailing address

3206 CONWAY RD STE 5
ORLANDO FL
32812-7316
US

V. Phone/Fax

Practice location:
  • Phone: 407-930-6577
  • Fax: 407-855-1885
Mailing address:
  • Phone: 407-930-6577
  • Fax: 407-855-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JEANNETTE MAEZTU
Title or Position: DIRECTOR
Credential:
Phone: 407-930-6577