Mederi of Orange County, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

21635096 Issued in FL

Legal business name

MEDERI OF ORANGE COUNTY, INC.

Practice address

1071 Port Malabar Blvd NE
Suite 205
Palm Bay, FL 32905-5161

Phone

(321) 308-0321

Fax

(321) 308-0329

NPI assigned

Sep 27, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. C. Steven Guenthner

Title

Sr. VP,Cfo

Phone

(502) 891-1042

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mederi of Brevard County Doing business as

Tax ID family

Mederi of Brevard County2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mederi of Orange County, Inc.

  • Home Health Agency
  • Maitland, FL
  • NPI 1932195088
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376539155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 ORMSBY STATION RD",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234081",
            "telephone_number": "502-891-1000",
            "fax_number": "502-891-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE",
            "address_2": "SUITE 205",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "321-308-0321",
            "fax_number": "321-308-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDERI OF ORANGE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUENTHNER",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "SR. VP,CFO",
        "authorized_official_telephone_number": "502-891-1042",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "21635096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "HE3",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mederi of Brevard County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alisa McGee, LCSW
• Rebecca McGinn
• Tyreak Albert McLarty, RBT
• Lenworth McLean
• Mecnb, LLC
• Medfast Urgent Care Centers, LLC
• Medfast Urgent Care Centers, LLC
• Medfast Urgent Care Centers, LLC
• Medical Solutions
• Medical Technology Transfer Corporation

• All providers in Palm Bay, FL
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.