Provider Demographics
NPI:1295479343
Name:DYNASTY SENIOR CARE INC
Entity type:Organization
Organization Name:DYNASTY SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:GAITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-265-4755
Mailing Address - Street 1:7800 W SAND LAKE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5198
Mailing Address - Country:US
Mailing Address - Phone:321-299-0909
Mailing Address - Fax:
Practice Address - Street 1:7800 W SAND LAKE RD STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5198
Practice Address - Country:US
Practice Address - Phone:321-299-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care