MEDICARE: ORANGE HOME HEALTH AGENCY, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HHA299992932	OTHER	FL	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1225151699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORANGE HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	1650 SAND LAKE RD
Second Line	:	SUITE 212
City	:	ORLANDO
State	:	FL
Zip	:	32809-7681
Country	:	US
Telephone Number	:	407-240-1196
Fax Number	:	407-858-5730

Provider Business Practice Location Address
First Line	:	1650 SAND LAKE RD
Second Line	:	SUITE 212
City	:	ORLANDO
State	:	FL
Zip	:	32809-7681
Country	:	US
Telephone Number	:	407-240-1196
Fax Number	:	407-858-5730

Authorized Official
Title or Position	:	C.E.O
Name	:	MR. THEODROS GELAGAY
Credential	:
Telephone Number	:	407-240-1196

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	05/09/2008

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