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General NPI Number Information
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NPI Number | 1578059739
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Entity Type | Organization
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Legal Business Name | PWT NURSE CONSULTANTS & HOME SERVICES INC
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 7034 MINIPPI DR
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City | ORLANDO
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State | FL
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Zip | 32818-3345
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Country | US
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Telephone | 407-925-7237
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Fax |
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Provider Business Mailing Address
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Address Line | 1746 E SILVER STAR RD # 107
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City | OCOEE
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State | FL
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Zip | 34761-7014
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Country | US
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Telephone | 407-925-7237
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PHYLLIS TYSON
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Credential | RN
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Telephone | 407-925-7237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2529832
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 0700506
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 235270
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 235270
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License Number State | FL
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