=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770614935
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CSI NURSE WORLD INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 10/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2211 LEE RD STE 211
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-1846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-629-1141
-----------------------------------------------------
Fax | 407-644-4102
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33 S STATE ST FL 5
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60603-2804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-762-9999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF LEGAL OFFICE, SECRETARY
-----------------------------------------------------
Name | MR. JOSEPH BONACCORSI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 312-762-9999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3747A0650X
-----------------------------------------------------
Taxonomy Name | Attendant Care Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------