MEDICARE: POSITIVE ASSISTANCE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	85-8018130580C-7	OTHER	FL	85-8018130580C-7

General Provider Information

NPI Number	:	1023608999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE ASSISTANCE, INC.

Provider Business Mailing Address
First Line	:	7156 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6751
Country	:	US
Telephone Number	:	407-412-6569
Fax Number	:	407-930-9443

Provider Business Practice Location Address
First Line	:	7156 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6751
Country	:	US
Telephone Number	:	407-993-6193
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ANDRE ANTENOR
Credential	:
Telephone Number	:	863-242-3322

Provider Enumeration Date	:	01/24/2021
Last Update Date	:	07/19/2022

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Directions to “POSITIVE ASSISTANCE, INC. ” Practice Location

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