MEDICARE: A CORE CONNECTION SERVICES AND CONSULTING, 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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801371299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CORE CONNECTION SERVICES AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2135 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4983
Country	:	US
Telephone Number	:	407-789-2673
Fax Number	:	407-612-2359

Provider Business Practice Location Address
First Line	:	2135 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4983
Country	:	US
Telephone Number	:	407-789-2673
Fax Number	:	407-612-2359

Authorized Official
Title or Position	:	COO
Name	:	KELLY GREENE
Credential	:
Telephone Number	:	407-639-4047

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	02/25/2025

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