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Organization
MEDERI OF ORANGE COUNTY, INC.
Active
Organization
MEDERI OF ORANGE COUNTY, INC.
Active
Other names
Mederi of Brevard County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. STEVEN GUENTHNER (SR. VP,CFO)
(502) 891-1042
Entity
Organization
Contact information
Practice address
1071 PORT MALABAR BLVD NE, SUITE 205, PALM BAY, FL 32905-5161
(321) 308-0321
(321) 308-0329
Mailing address
9510 ORMSBY STATION RD, SUITE 300, LOUISVILLE, KY 40223-4081
(502) 891-1000
(502) 891-8067
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
21635096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HE3
BLUE CROSS-BLUE SHIELD
FL
Enumeration date
09/27/2005
Last updated
08/22/2020
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