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General NPI Number Information
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NPI Number | 1043120173
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Entity Type | Organization
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Legal Business Name | BRIDGE OF INDEPENDENCE LLC
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 2015 ERVING CIR APT 5108
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City | OCOEE
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State | FL
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Zip | 34761-6855
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Country | US
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Telephone | 407-868-0229
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Fax |
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Provider Business Mailing Address
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Address Line | 1545 MARDEN RIDGE LOOP APT 301
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City | APOPKA
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State | FL
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Zip | 32703-6980
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Country | US
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Telephone | 407-868-0229
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. STACY ANTONIO ROBINSON SR.
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Credential |
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Telephone | 407-868-0229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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