MEDICARE: SENIOR ONE 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1184107294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR ONE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	7351 WILES RD STE 107
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7351 WILES RD STE 107
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4106
Country	:	US
Telephone Number	:	561-774-6692
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GIOVANNI CARRILLO
Credential	:
Telephone Number	:	561-774-6692

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	09/13/2018

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Directions to “SENIOR ONE SOLUTIONS, LLC ” Practice Location

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