Healthcare Provider Details

I. General information

NPI: 1346488624
Provider Name (Legal Business Name): MRM ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N DILLARD ST SUITE 102
WINTER GARDEN FL
34787-2853
US

IV. Provider business mailing address

410 N DILLARD ST SUITE 102
WINTER GARDEN FL
34787-2853
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-0720
  • Fax: 407-386-3210
Mailing address:
  • Phone: 407-877-0720
  • Fax: 407-386-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. RAOUL M GUERRA
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 407-877-0720