=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528102837
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SALVANT HOME CARE AGENCY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8607 WHITE ROSE DR
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32818-5680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-373-0891
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8607 WHITE ROSE DR
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32818-5680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-373-0891
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MR. JEAN RONY SALVANT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-719-6162
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------