Provider Demographics
NPI:1548779119
Name:MIRACLE CARE RESPONDERS LLC
Entity Type:Organization
Organization Name:MIRACLE CARE RESPONDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINT JEAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:772-204-4987
Mailing Address - Street 1:PO BOX 678827
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32867-8827
Mailing Address - Country:US
Mailing Address - Phone:407-801-0897
Mailing Address - Fax:
Practice Address - Street 1:638 FIELDSTREAM BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-7208
Practice Address - Country:US
Practice Address - Phone:407-801-0897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234355251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health