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General NPI Number Information
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NPI Number | 1609387489
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Entity Type | Organization
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Legal Business Name | OASIS OF SERENITY HOMECARE, LLC
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 368 CYPRESS KNEE LN
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City | LAKE MARY
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State | FL
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Zip | 32746-7106
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Country | US
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Telephone | 407-513-2485
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Fax | 407-871-2378
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Provider Business Mailing Address
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Address Line | 368 CYPRESS KNEE LN
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City | LAKE MARY
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State | FL
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Zip | 32746-7106
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Country | US
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Telephone | 407-513-2485
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Fax | 407-871-2378
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. MAY FLOR ESTORQUE HARRIS
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Credential |
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Telephone | 407-474-7427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 234704
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License Number State | FL
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