Provider Demographics
NPI:1336208867
Name:ORLANDO INTERIM ACQUISITION COMPANY, LLC
Entity Type:Organization
Organization Name:ORLANDO INTERIM ACQUISITION COMPANY, LLC
Other - Org Name:INTERIM HEALTHCARE OF GREATER ORLANDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-645-3211
Mailing Address - Street 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2285
Mailing Address - Country:US
Mailing Address - Phone:407-645-3211
Mailing Address - Fax:407-628-2853
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 355
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2285
Practice Address - Country:US
Practice Address - Phone:407-740-5284
Practice Address - Fax:407-539-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL205690961251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651711100Medicaid
FL651711100Medicaid