Provider Demographics
NPI:1205268661
Name:OSCEOLA SUNRISE SPECIAL CARE
Entity type:Organization
Organization Name:OSCEOLA SUNRISE SPECIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-518-6688
Mailing Address - Street 1:3053 BIG SKY BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5615
Mailing Address - Country:US
Mailing Address - Phone:407-518-6688
Mailing Address - Fax:321-697-7086
Practice Address - Street 1:3053 BIG SKY BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5615
Practice Address - Country:US
Practice Address - Phone:407-518-6688
Practice Address - Fax:321-697-7086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683752296Medicaid
FL683752298Medicaid
FL687815600Medicaid