MEDICARE: WELLSPRING HEALTH SERVICES

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	251E00000X	Home Health Agency	CERT 1921	FL

General Provider Information

NPI Number	:	1881894160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRING HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 608033
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32860-8033
Country	:	US
Telephone Number	:	407-522-5201
Fax Number	:

Provider Business Practice Location Address
First Line	:	6239 EDGEWATER DR
Second Line	:	BLDG N2 SUITE D3
City	:	ORLANDO
State	:	FL
Zip	:	32810-4736
Country	:	US
Telephone Number	:	407-522-5201
Fax Number	:	407-522-5204

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MR. DENNIS WILLIAM MCMILLION
Credential	:
Telephone Number	:	407-522-5201

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	07/24/2007

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Directions to “WELLSPRING HEALTH SERVICES ” Practice Location

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