Provider Demographics
NPI:1023608999
Name:POSITIVE ASSISTANCE, INC.
Entity type:Organization
Organization Name:POSITIVE ASSISTANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-242-3322
Mailing Address - Street 1:7156 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6751
Mailing Address - Country:US
Mailing Address - Phone:407-412-6569
Mailing Address - Fax:407-930-9443
Practice Address - Street 1:7156 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6751
Practice Address - Country:US
Practice Address - Phone:407-993-6193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114106200Medicaid
FL85-8018130580C-7Other85-8018130580C-7