MEDICARE: CHAMPION HOME CARE SOLUTIONS, LLC

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

General Provider Information

NPI Number	:	1053149088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPION HOME CARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	7215 JONQUIL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-5808
Country	:	US
Telephone Number	:	407-305-1925
Fax Number	:

Provider Business Practice Location Address
First Line	:	7215 JONQUIL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-5808
Country	:	US
Telephone Number	:	407-305-1925
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JARVIN VINES
Credential	:
Telephone Number	:	407-305-1925

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	07/22/2024

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Directions to “CHAMPION HOME CARE SOLUTIONS, LLC ” Practice Location

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