Healthcare Provider Details

I. General information

NPI: 1134120991
Provider Name (Legal Business Name): TEAMCARE INFUSION ORLANDO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CENTRAL PARK DR STE 500
SANFORD FL
32771-6307
US

IV. Provider business mailing address

1100 CENTRAL PARK DR SUITE 500
SANFORD FL
32771-6305
US

V. Phone/Fax

Practice location:
  • Phone: 407-328-8787
  • Fax: 407-330-4746
Mailing address:
  • Phone: 407-328-8787
  • Fax: 407-330-4746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH20960
License Number StateFL

VIII. Authorized Official

Name: MARK SCHNEIDER
Title or Position: PRESIDENT
Credential:
Phone: 407-328-8787