Organization
CONSTELLATION SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORALIS CALDERON (OWNER)
(407) 902-5919
Entity
Organization
Contact information
Practice address
5726 OLD CHENEY HWY, ORLANDO, FL 32807-3525
(407) 900-5278
Mailing address
7726 WINEGARD RD STE 53, ORLANDO, FL 32809-7147
(407) 900-5278
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114731200
—
FL
Enumeration date
12/26/2022
Last updated
11/18/2024
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