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NPI Code Detail

MEDICARE: CENTRAL FLORIDA FAMILY HEALTH CENTER, INC.

MEDICARE: CENTRAL FLORIDA FAMILY HEALTH CENTER, INC.
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
1261QF0400XFederally Qualified Health Center (FQHC)FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497786818
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL FLORIDA FAMILY HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 4930 E. LAKE MARY BLVD.
Second Line :
City : SANFORD
State : FL
Zip : 32771
Country : US
Telephone Number : 407-322-8645
Fax Number : 407-330-5074
Provider Business Practice Location Address
First Line : 5730 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-4366
Country : US
Telephone Number : 407-956-4333
Fax Number : 407-956-4337
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : JANELLE DUNN
Credential :
Telephone Number : 407-322-8645
Provider Enumeration Date : 07/05/2006
Last Update Date : 12/28/2020

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1083631741 — MISS CAROL KAY BIERY A.R.N.P.
Practice Location Address:
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Practice Fax:
1144335514 — JAIME CABALLERO MD
Practice Location Address:
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Practice Fax:
1275693202 — CENTRAL FLORIDA FAMILY HEALTH CENTER
Practice Location Address:
5730 LAKE UNDERHILL RD
ORLANDO, FL
32807-4366
Practice Phone: 407-322-8645
Practice Fax: 407-269-8986

Directions to “CENTRAL FLORIDA FAMILY HEALTH CENTER, INC. ” Practice Location

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