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General NPI Number Information
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NPI Number | 1669729315
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Entity Type | Organization
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Legal Business Name | CARE CONNECTION
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 2788 HIGHLAND VIEW CIR
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City | CLERMONT
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State | FL
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Zip | 34711-5893
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Country | US
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Telephone | 352-243-4725
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Fax | 352-243-4725
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Provider Business Mailing Address
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Address Line | 2788 HIGHLAND VIEW CIR
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City | CLERMONT
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State | FL
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Zip | 34711-5893
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Country | US
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Telephone | 352-243-4725
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Fax | 352-243-4725
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN B FRIEND
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Credential | RN
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Telephone | 352-243-4725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | RN475332
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License Number State | FL
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