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General NPI Number Information
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NPI Number | 1811121056
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Entity Type | Organization
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Legal Business Name | PRIME NURSING
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Dates
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Enumeration Date | 05/01/2009
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 89 DOBSON ST
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City | ORLANDO
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State | FL
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Zip | 32805-1913
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Country | US
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Telephone | 407-522-2711
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Fax | 407-286-7982
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Provider Business Mailing Address
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Address Line | 89 DOBSON ST
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City | ORLANDO
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State | FL
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Zip | 32805-1913
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Country | US
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Telephone | 407-522-2711
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Fax | 407-286-7982
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Authorized Official
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Title or Position | REGISTER NURSE/MANAGER
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Name | MRS. ANGELA LAING
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Credential | BSN
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Telephone | 407-522-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 264610199
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License Number State | FL
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