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General NPI Number Information
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NPI Number | 1548435852
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Entity Type | Organization
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Legal Business Name | MARTHA'S HOME CARE
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 9165 LEE VISTA BLVD APT 107
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City | ORLANDO
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State | FL
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Zip | 32829-8309
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Country | US
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Telephone | 407-275-3264
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Fax | 407-275-3264
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Provider Business Mailing Address
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Address Line | P.O. BOX 623162
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City | OVIEDO
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State | FL
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Zip | 32762-8309
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Country | US
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Telephone | 407-953-4221
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Fax | 407-275-3264
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Authorized Official
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Title or Position | VP
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Name | MISS GLORIA FLOREZ
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Credential |
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Telephone | 407-953-4221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 230485
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License Number State | FL
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