MEDICARE: OASIS UNITED TRANSFORMATION COMMUNITY DEVELOPMENT CORPORATION

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	251B00000X	Case Management Agency		FL

General Provider Information

NPI Number	:	1336481563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS UNITED TRANSFORMATION COMMUNITY DEVELOPMENT CORPORATION

Provider Business Mailing Address
First Line	:	3404 N ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-3411
Country	:	US
Telephone Number	:	407-730-6977
Fax Number	:	407-730-6978

Provider Business Practice Location Address
First Line	:	3404 N ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-3411
Country	:	US
Telephone Number	:	407-730-6977
Fax Number	:	407-730-6978

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEBREITA D TAYLOR
Credential	:
Telephone Number	:	407-461-8685

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	03/26/2013

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