Pristine Homecare

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PRISTINE HOMECARE

Practice address

1320 N Semoran Blvd
Suite 108
Orlando, FL 32807

Phone

(407) 955-9483

NPI assigned

Dec 18, 2019

Organization subpart

No

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

Authorized official

Name

Mateo Martinez

Title

Owner

Phone

(215) 490-5705

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mind & Mobility Doing business as

Locations

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1992343255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 EXECUTIVE PARK CT STE 1016A",
            "address_2": "STE 1016A",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "215-490-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N SEMORAN BLVD",
            "address_2": "SUITE 108",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32807",
            "telephone_number": "407-955-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE HOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "MATEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-490-5705"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113083400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind & Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Raymond Printup
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• Veronica-Jo Prisco, LCSW
• Bernice A Pritchett, M.D.
• Cedric V Pritchett, MD
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• Private Healthcare Facilities
• Private Practice Counseling Inc

• In Home Supportive Care Agency in Orlando, FL
• Providers in Orlando, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.