MEDICARE: CENTRAL FLORIDA QUALITY CARE SERVICES, 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	251E00000X	Home Health Agency	21783096	FL

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

General Provider Information

NPI Number	:	1033554449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA QUALITY CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	723 E COLONIAL DR STE 200
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4662
Country	:	US
Telephone Number	:	407-478-1368
Fax Number	:	407-478-1370

Provider Business Practice Location Address
First Line	:	100 E NEW YORK AVE STE 320
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32724-5576
Country	:	US
Telephone Number	:	407-478-1368
Fax Number	:	407-478-1370

Authorized Official
Title or Position	:	OWNER/CHAIRPERSON
Name	:	MR. VECHEL GRIFFON
Credential	:
Telephone Number	:	407-478-1368

Provider Enumeration Date	:	04/30/2013
Last Update Date	:	08/02/2019

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