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General NPI Number Information
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NPI Number | 1336208867
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Entity Type | Organization
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Legal Business Name | ORLANDO INTERIM ACQUISITION COMPANY, LLC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 1890 STATE ROAD 436 SUITE 355
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City | WINTER PARK
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State | FL
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Zip | 32792-2285
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Country | US
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Telephone | 407-740-5284
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Fax | 407-539-1463
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Provider Business Mailing Address
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Address Line | 1890 STATE ROAD 436 SUITE 300
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City | WINTER PARK
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State | FL
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Zip | 32792-2285
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Country | US
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Telephone | 407-645-3211
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Fax | 407-628-2853
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Authorized Official
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Title or Position | MANAGER
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Name | MR. KENNETH H. SCHULTZ
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Credential |
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Telephone | 407-645-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 205690961
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License Number State | FL
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