MEDICARE: CENTRAL FLORIDA RESEARCH 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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1861544843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA RESEARCH INC

Provider Business Mailing Address
First Line	:	245 N SEMINOLE AVE
Second Line	:	P.O.BOX 599
City	:	LAKE ALFRED
State	:	FL
Zip	:	33850-2119
Country	:	US
Telephone Number	:	863-956-3538
Fax Number	:	863-956-0839

Provider Business Practice Location Address
First Line	:	245 N SEMINOLE AVE
Second Line	:
City	:	LAKE ALFRED
State	:	FL
Zip	:	33850-2119
Country	:	US
Telephone Number	:	863-956-3538
Fax Number	:	863-956-0839

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. THOMAS JAMES LONG
Credential	:
Telephone Number	:	863-956-3538

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/22/2020

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