Provider Demographics
NPI:1609120864
Name:ELITE ELDERLY CARE LLC
Entity Type:Organization
Organization Name:ELITE ELDERLY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUKHU-GAFOOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-857-5063
Mailing Address - Street 1:15009 LAKE AZURE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4932
Mailing Address - Country:US
Mailing Address - Phone:407-857-5063
Mailing Address - Fax:407-286-6363
Practice Address - Street 1:15009 LAKE AZURE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-4932
Practice Address - Country:US
Practice Address - Phone:407-857-5063
Practice Address - Fax:407-286-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12251310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility