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NPI Code Detail

MEDICARE: AGE INPLACE HOMECARE LLC

MEDICARE: AGE INPLACE HOMECARE 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
1363LF0000XFamily Nurse PractitionerARNP1204432FL

General Provider Information

NPI Number : 1174573257
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGE INPLACE HOMECARE LLC
Provider Business Mailing Address
First Line : 14234 ANASTASIA LN
Second Line :
City : ORLANDO
State : FL
Zip : 32828-4804
Country : US
Telephone Number : 407-381-4395
Fax Number : 407-282-1453
Provider Business Practice Location Address
First Line : 14234 ANASTASIA LN
Second Line :
City : ORLANDO
State : FL
Zip : 32828-4804
Country : US
Telephone Number : 407-381-4395
Fax Number : 407-282-1453
Authorized Official
Title or Position : OWNER
Name : JOYCE MRAZ
Credential : ARNP/MBR
Telephone Number : 407-381-4395
Provider Enumeration Date : 05/11/2006
Last Update Date : 10/04/2007

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Directions to “AGE INPLACE HOMECARE LLC ” Practice Location

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