Organization
PWT NURSE CONSULTANTS & HOME SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS TYSON RN (ADMINISTRATOR)
(407) 925-7237
Entity
Organization
Contact information
Practice address
7034 MINIPPI DR, ORLANDO, FL 32818-3345
(407) 925-7237
Mailing address
1746 E SILVER STAR RD # 107, OCOEE, FL 34761-7014
(407) 925-7237
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2529832
FL
253Z00000X
In Home Supportive Care Agency
Primary
235270
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
0700506
FL
372600000X
Adult Companion
235270
FL
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015366700
—
FL
Enumeration date
07/10/2018
Last updated
07/10/2018
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