MEDICARE: FLORIDA COMMUNITY HEALTH CENTERS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	261QF0400X	Federally Qualified Health Center (FQHC)
3	207RI0200X	Infectious Disease Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1578669917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA COMMUNITY HEALTH CENTERS INC

Provider Business Mailing Address
First Line	:	4450 S TIFFANY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3241
Country	:	US
Telephone Number	:	561-844-9443
Fax Number	:	561-844-1013

Provider Business Practice Location Address
First Line	:	4450 S TIFFANY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3241
Country	:	US
Telephone Number	:	561-844-9443
Fax Number	:	561-844-1013

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	DR. MICHAEL F GERVASI
Credential	:	D.O.
Telephone Number	:	561-844-9443

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	09/06/2011

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Directions to “FLORIDA COMMUNITY HEALTH CENTERS INC ” Practice Location

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