Healthcare Provider Details

I. General information

NPI: 1497674204
Provider Name (Legal Business Name): PORCHA RUCKER HOMEMAKER/COMPANION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4451 PIEDMONT ST
ORLANDO FL
32811-4526
US

IV. Provider business mailing address

4451 PIEDMONT ST
ORLANDO FL
32811-4526
US

V. Phone/Fax

Practice location:
  • Phone: 321-358-5544
  • Fax:
Mailing address:
  • Phone: 321-358-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number241851
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: