Individual provider · NPI-1
Carroll Lolita Gordon
Home Health Aide · Ocoee, FL
NPI number1326646027
StatusActive
Last updated in NPPESOct 14, 2020
Details
- NPI
- 1326646027
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Carroll Lolita Gordon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 14, 2020
- Certification date
- Oct 14, 2020
- Last updated
- Oct 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | FL | Yes |
Practice location
1119 Sand Creek LoopOcoee, FL 34761
Phone 407-346-9498
Mailing address
Po Box 617045Orlando, FL 32861
Phone 407-346-9498
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