MEDICARE: HOME & LIFESTYLE 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1225817919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME & LIFESTYLE SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	2855 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-405-2496
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-405-2496
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. MARCIA VIRGINIA NESTOR
Credential	:
Telephone Number	:	407-405-2496

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	09/22/2023

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