Provider Demographics
NPI:1891290912
Name:OBLACARESOLUTIONS
Entity Type:Organization
Organization Name:OBLACARESOLUTIONS
Other - Org Name:OBLACARESOLUTIONSLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:CHAMORRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-891-4040
Mailing Address - Street 1:3443 13 TH ST
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4052
Mailing Address - Country:US
Mailing Address - Phone:407-891-4040
Mailing Address - Fax:407-890-1223
Practice Address - Street 1:3443 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4052
Practice Address - Country:US
Practice Address - Phone:407-891-4040
Practice Address - Fax:407-890-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL023771700376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023771700Medicaid