MEDICARE: ORANGE CARE 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1689360281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORANGE CARE LLC

Provider Business Mailing Address
First Line	:	11515 MEADOWRUN CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-9066
Country	:	US
Telephone Number	:	361-216-4094
Fax Number	:

Provider Business Practice Location Address
First Line	:	11515 MEADOWRUN CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-9066
Country	:	US
Telephone Number	:	361-216-4094
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JERROLYNN JUSTUSSON
Credential	:
Telephone Number	:	800-743-0396

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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Directions to “ORANGE CARE LLC ” Practice Location

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