=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124242607
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORLANDO CAREGIVERS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/13/2007
-----------------------------------------------------
Last Update Date | 09/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11715 ORPINGTON ST SUITE E
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32817-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-992-9958
-----------------------------------------------------
Fax | 407-641-8118
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11715 ORPINGTON ST SUITE E
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32817-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-992-9958
-----------------------------------------------------
Fax | 407-641-8118
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LAIMA WARNECKE
-----------------------------------------------------
Credential | MD, MBA
-----------------------------------------------------
Telephone | 407-992-9958
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 229936
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------