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General NPI Number Information
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NPI Number | 1548779119
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Entity Type | Organization
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Legal Business Name | MIRACLE CARE RESPONDERS LLC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 638 FIELDSTREAM BLVD
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City | ORLANDO
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State | FL
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Zip | 32825-7208
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Country | US
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Telephone | 407-801-0897
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 678827
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City | ORLANDO
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State | FL
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Zip | 32867-8827
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Country | US
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Telephone | 407-801-0897
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEAN SAINT JEAN JR.
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Credential |
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Telephone | 772-204-4987
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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 | 234355
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License Number State | FL
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