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General NPI Number Information
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NPI Number | 1750511291
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Entity Type | Organization
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Legal Business Name | CARIBBEAN COMMUNITY CONNECTION OF ORLANDO, INC.
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 122 W SPROULE AVE
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City | KISSIMMEE
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State | FL
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Zip | 34741-5048
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Country | US
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Telephone | 407-473-7616
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Fax | 321-428-3600
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Provider Business Mailing Address
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Address Line | 620 NEW MEXICO WOODS CT
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City | ORLANDO
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State | FL
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Zip | 32824-7552
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Country | US
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Telephone | 407-473-1442
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Fax | 407-522-7617
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Authorized Official
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Title or Position | CEO
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Name | MRS. ANJIRO GABRIEL
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Credential | MPA
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Telephone | 407-473-1442
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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 |
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License Number State |
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