MEDICARE: CHILDREN'S HOME SOCIETY OF FLORIDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1205983806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOME SOCIETY OF FLORIDA

Provider Business Mailing Address
First Line	:	1485 S SEMORAN BLVD
Second Line	:	SUITE 1448
City	:	WINTER PARK
State	:	FL
Zip	:	32792-5533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W 23RD ST
Second Line	:	SUITE H-100
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3936
Country	:	US
Telephone Number	:	850-747-5411
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID BUNDY
Credential	:
Telephone Number	:	321-397-3000

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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Directions to “CHILDREN'S HOME SOCIETY OF FLORIDA ” Practice Location

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