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General NPI Number Information
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NPI Number | 1356809198
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Entity Type | Organization
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Legal Business Name | MEDICAL FOSTER HOMES LLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 9670 LUPINE AVE
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City | ORLANDO
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State | FL
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Zip | 32824-8744
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Country | US
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Telephone | 321-622-0782
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 621883
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City | ORLANDO
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State | FL
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Zip | 32862-1883
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Country | US
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Telephone | 321-622-0782
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | PATRICIA LEDOUX
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Credential | MD
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Telephone | 321-622-0782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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