Provider Demographics
NPI:1124848825
Name:ORLANDO SENIOR CARE SERVICES LLC
Entity type:Organization
Organization Name:ORLANDO SENIOR CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-664-1783
Mailing Address - Street 1:11929 PIONEERS WAY APT 1221
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-2866
Mailing Address - Country:US
Mailing Address - Phone:631-664-1783
Mailing Address - Fax:
Practice Address - Street 1:3680 AVALON PARK EAST BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-9373
Practice Address - Country:US
Practice Address - Phone:631-664-1783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care