Healthcare Provider Details

I. General information

NPI: 1619028313
Provider Name (Legal Business Name): CORNERSTONE HOSPICE & PALLIATIVE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 LANE PARK RD
TAVARES FL
32778-9648
US

IV. Provider business mailing address

2445 LANE PARK RD
TAVARES FL
32778-9648
US

V. Phone/Fax

Practice location:
  • Phone: 352-343-1341
  • Fax: 352-343-0325
Mailing address:
  • Phone: 352-343-1341
  • Fax: 352-343-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number5019096
License Number StateFL

VIII. Authorized Official

Name: CRYSTAL BUCCIARELLI
Title or Position: VP, LEGAL SERVICES
Credential:
Phone: 813-871-8075