Provider Demographics
NPI:1124006036
Name:MEDCARE SERVICES OF ORLANDO, INC.
Entity Type:Organization
Organization Name:MEDCARE SERVICES OF ORLANDO, INC.
Other - Org Name:MEDCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/ L
Authorized Official - Phone:407-831-8833
Mailing Address - Street 1:794 BIG TREE DR UNIT 108
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-3553
Mailing Address - Country:US
Mailing Address - Phone:407-831-8833
Mailing Address - Fax:407-831-8834
Practice Address - Street 1:794 BIG TREE DR UNIT 108
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3553
Practice Address - Country:US
Practice Address - Phone:407-831-8833
Practice Address - Fax:407-831-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Z00000X, 225X00000X, 335E00000X
FLOT10429332B00000X
FLORF#93332B00000X
FLOT13163332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1313240001Medicare NSC