MEDICARE: MDSS 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
1	253Z00000X	In Home Supportive Care Agency		FL

Other Identifiers

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

General Provider Information

NPI Number	:	1205326444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDSS SERVICES LLC

Provider Business Mailing Address
First Line	:	2593 COURTLAND BLVD
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2543
Country	:	US
Telephone Number	:	386-218-3589
Fax Number	:	386-218-3769

Provider Business Practice Location Address
First Line	:	2593 COURTLAND BLVD
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2543
Country	:	US
Telephone Number	:	386-218-3589
Fax Number	:	386-218-3769

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MARIA DEL SOCORRO SUAREZ
Credential	:
Telephone Number	:	386-218-3589

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	06/16/2018

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