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NPI Code Detail

MEDICARE: INFINITE SUPPORT SERVICES LLC

MEDICARE: INFINITE SUPPORT SERVICES 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
1372500000XChore Provider23940FL
2163W00000XRegistered Nurse
3376J00000XHomemaker23940FL
4372600000XAdult Companion23940FL
53747A0650XAttendant Care Provider
6253Z00000XIn Home Supportive Care AgencyFL
7174200000XMeals Provider
8385H00000XRespite Care
9374U00000XHome Health Aide

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184136145
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFINITE SUPPORT SERVICES LLC
Provider Business Mailing Address
First Line : 17 E MAGNOLIA AVE STE 3-B
Second Line :
City : EUSTIS
State : FL
Zip : 32726-3472
Country : US
Telephone Number : 407-986-7557
Fax Number : 352-769-4074
Provider Business Practice Location Address
First Line : 1345 N GRANDVIEW ST
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-3811
Country : US
Telephone Number : 407-986-7557
Fax Number : 352-504-4354
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. DEPORSHIA ARVETTA BLACKMON
Credential :
Telephone Number : 407-986-7557
Provider Enumeration Date : 10/31/2017
Last Update Date : 02/02/2026

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Directions to “INFINITE SUPPORT SERVICES LLC ” Practice Location

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