Organization
IMMACULATE HOMECARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MYRIAM I PLONQUE RN-MSN (PRESIDENT)
(315) 723-4157
Entity
Organization
Contact information
Practice address
2204 ASHLAND BLVD, ORLANDO, FL 32808-4906
(315) 723-4157
Mailing address
2204 ASHLAND BLVD, ORLANDO, FL 32808-4906
(315) 723-4157
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2020
Last updated
02/28/2020
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