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General NPI Number Information
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NPI Number | 1245827328
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Entity Type | Organization
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Legal Business Name | BAC HOUSE CALLS ADULT & FAMILY HEALTH
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1317 EDGEWATER DR # 3367
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 407-863-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 MARSHFIELD PRESERVE WAY
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City | KISSIMMEE
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State | FL
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Zip | 34746-2272
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Country | US
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Telephone | 407-863-6389
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BIRGET ANN CORDIS
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Credential | APRN
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Telephone | 407-863-6389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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