MEDICARE: EASTER ASIS HANCOCK

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	171M00000X	Case Manager/Care Coordinator

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

General Provider Information

NPI Number	:	1871800730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EASTER ASIS HANCOCK

Provider Business Mailing Address
First Line	:	1096 PLAZA DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-4069
Country	:	US
Telephone Number	:	407-758-2371
Fax Number	:	407-277-7859

Provider Business Practice Location Address
First Line	:	1096 PLAZA DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34743-4069
Country	:	US
Telephone Number	:	407-758-2371
Fax Number	:	407-277-7859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	09/13/2010

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Directions to “ EASTER ASIS HANCOCK ” Practice Location

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