MEDICARE: IN HOME PRIMARY CARE INC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1841655180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME PRIMARY CARE INC

Provider Business Mailing Address
First Line	:	PO BOX 690722
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32869-0722
Country	:	US
Telephone Number	:	407-720-8765
Fax Number	:	407-386-6881

Provider Business Practice Location Address
First Line	:	11380 ASHBORO DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-9022
Country	:	US
Telephone Number	:	407-720-8765
Fax Number	:	407-386-6881

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOSE FRANCISCO PEREIRA
Credential	:	ARNP
Telephone Number	:	407-720-8765

Provider Enumeration Date	:	12/30/2015
Last Update Date	:	02/26/2016

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