MEDICARE: CARE 1ST OF ORLANDO 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

General Provider Information

NPI Number	:	1194330803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE 1ST OF ORLANDO INC

Provider Business Mailing Address
First Line	:	2211 LEE RD STE 205A
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-1846
Country	:	US
Telephone Number	:	407-622-0589
Fax Number	:	888-506-5776

Provider Business Practice Location Address
First Line	:	2211 LEE RD STE 205A
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-1846
Country	:	US
Telephone Number	:	407-622-0589
Fax Number	:	888-506-5776

Authorized Official
Title or Position	:	OWNER
Name	:	LADY SERVILLAS
Credential	:	RN/PT
Telephone Number	:	305-318-5115

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	10/23/2020

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