PROVIDENCEPASS, LLC (NPI# 1811554546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811554546 |
| Entity Type | Organization |
| Organization Name | PROVIDENCEPASS, LLC |
| Practice Address |
741 Front St Ste 210 Kissimmee FL 34747-4992 |
| Practice Telephone | 8442442840 |
| Mailing Telephone | 8442442840 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | JENNIFER DEL GIUDICE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8442442840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
741 FRONT ST STE 210 |
| City | KISSIMMEE |
| State | FL |
| Zip Code | 34747-4992 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861974073 | Keiler Heberto Moreno Rivero, P.a. | Internal Medicine | 2954 Mallory Cir #200, Kissimmee, FL 34747 | 2018-09-04 |
| 1437644952 | Tri-county Nursing and Rehabilitation Center Inc | Skilled Nursing Facility | 1290 Celebration Blvd, Kissimmee, FL 34747 | 2018-06-27 |
| 1669918579 | Kyle Mcclurg | Specialist/Technologist | 700 S Victory Way, Kissimmee, FL 34747 | 2017-01-17 |
| 1194277913 | Norma Ivelisse Arzola | Counselor | 7519 Pellham Way, Kissimmee, FL 34747 | 2016-10-27 |
| 1528416625 | Guillermo Rivera | Counselor | 8401 Titkos Drive Apt 201, Kissimmee, FL 34747 | 2016-05-31 |
| 1659780625 | Keiler Moreno Rivero | Internal Medicine | 2954 Mallory Cir, Suite 200, Kissimmee, FL 34747 | 2014-08-04 |
| 1538596309 | Chad Black Md, LLC | Family Medicine | 610 Sycamore Street Suite 130, Celebration, FL 34747 | 2013-10-10 |
| 1598046344 | Adventist Health System/sunbelt, Inc. | Non-Pharmacy Dispensing Site | 8201 W. Irlo Bronson Hwy, Kissimmee, FL 34747 | 2011-09-07 |
| 1447467170 | Matthew W Johnston | Orthopaedic Surgery | 410 Celectration Place, Suite 106, Celebration, FL 34747 | 2007-05-16 |
| 1457563538 | Eric Edwin Malek | Specialist/Technologist | 700 South Victory Way, Kissimmee, FL 34747 | 2007-05-03 |
| Find all providers in zip 34747 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313595 | Smart Scholars LLC | Counselor | 2220 E Irlo Bronson Memorial Hwy Ste 8, Kissimmee, FL 34744-4411 | 2020-10-15 |
| 1851918239 | Natanya Quinones Bracero | Counselor | 401 Fountainhead Cir Unit 156, Kissimmee, FL 34741-3244 | 2020-07-01 |
| 1043846124 | Jasmine Marie Smith | Counselor | 431 Brookfield Dr, Kissimmee, FL 34758-4143 | 2020-03-20 |
| 1437784659 | Karisma Vicioso | Counselor | 2839 Running Brook Cir, Kissimmee, FL 34744-9313 | 2020-03-09 |
| 1639715196 | Lisa Ann Alvarez | Counselor | 2705 Wolcott Ln, Kissimmee, FL 34747-1817 | 2019-11-20 |
| 1891330189 | Ketsia Alexandre | Counselor | 2401 Hamilton Branch Ct, Kissimmee, FL 34758-0069 | 2019-11-11 |
| 1407497373 | Stacy Thiry | Counselor | 3404 Misty Ln, Kissimmee, FL 34746-2827 | 2019-10-02 |
| 1265084768 | Shanira Sanchez | Counselor | 1176 Cypress Glen Cir, Kissimmee, FL 34741-7560 | 2019-07-15 |
| 1225597784 | Leila Rosado | Counselor | All Family, 120 Broadway Suite 204, Kissimmee, FL 34741 | 2019-03-14 |
| 1093273641 | Ellarie Lisbon | Counselor | 258 Grouper Ct, Kissimmee, FL 34759-4837 | 2019-03-03 |
| Find all providers in KISSIMMEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.