Healthcare Provider Details

I. General information

NPI: 1083128961
Provider Name (Legal Business Name): TOTAL CARE HOME SERVICES OF USA, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 LEE RD STE 120A
WINTER PARK FL
32789
US

IV. Provider business mailing address

1936 LEE RD STE 120A
WINTER PARK FL
32789-7201
US

V. Phone/Fax

Practice location:
  • Phone: 407-637-2390
  • Fax: 407-637-2370
Mailing address:
  • Phone: 76-372-3904
  • Fax: 407-637-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30211971
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number30211971
License Number StateFL

VIII. Authorized Official

Name: MARIAFELIX VALDES
Title or Position: PRESIDENT
Credential:
Phone: 786-718-0953