MEDICARE: FENELUS GROUP CARE FACILITY 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	374U00000X	Home Health Aide
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1285582692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FENELUS GROUP CARE FACILITY LLC

Provider Business Mailing Address
First Line	:	7827 REX HILL TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-8753
Country	:	US
Telephone Number	:	407-432-9498
Fax Number	:	407-432-9498

Provider Business Practice Location Address
First Line	:	6361 RUTHIE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-2254
Country	:	US
Telephone Number	:	407-432-9498
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PHILIPPE FENELUS
Credential	:
Telephone Number	:	407-432-9498

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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