Provider Demographics
NPI:1134120991
Name:TEAMCARE INFUSION ORLANDO INC
Entity Type:Organization
Organization Name:TEAMCARE INFUSION ORLANDO INC
Other - Org Name:TEAMCARE INFUSION ORLANDO INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-328-8787
Mailing Address - Street 1:1100 CENTRAL PARK DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6305
Mailing Address - Country:US
Mailing Address - Phone:407-328-8787
Mailing Address - Fax:407-330-4746
Practice Address - Street 1:1100 CENTRAL PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6307
Practice Address - Country:US
Practice Address - Phone:407-328-8787
Practice Address - Fax:407-330-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
FLPH209603336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2011508OtherPK
FL001495400Medicaid
4413050001Medicare NSC