MEDICARE: ATHALIAH HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	385H00000X	Respite Care
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548022536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHALIAH HOME CARE LLC

Provider Business Mailing Address
First Line	:	750 S ORANGE BLOSSOM TRL STE 140
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3159
Country	:	US
Telephone Number	:	407-791-7580
Fax Number	:	321-219-7192

Provider Business Practice Location Address
First Line	:	750 S ORANGE BLOSSOM TRL STE 140
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3159
Country	:	US
Telephone Number	:	407-791-7580
Fax Number	:	321-219-7192

Authorized Official
Title or Position	:	CEO
Name	:	MRS. GARDWINE BARBARA ROMAIN
Credential	:
Telephone Number	:	407-791-7580

Provider Enumeration Date	:	01/25/2024
Last Update Date	:	02/15/2024

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Directions to “ATHALIAH HOME CARE LLC ” Practice Location

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