Provider Demographics
NPI:1033119979
Name:HEALTH CENTER OF ORLANDO INC
Entity Type:Organization
Organization Name:HEALTH CENTER OF ORLANDO INC
Other - Org Name:THE HEALTH CENTER OF WINDERMERE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:T
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:407-420-2090
Mailing Address - Street 1:4875 CASON COVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-6302
Mailing Address - Country:US
Mailing Address - Phone:407-420-2090
Mailing Address - Fax:407-420-5998
Practice Address - Street 1:4875 CASON COVE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-6302
Practice Address - Country:US
Practice Address - Phone:407-420-2090
Practice Address - Fax:407-420-5998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF130470967314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022887700Medicaid
FL105960Medicare Oscar/Certification