Healthcare Provider Details
I. General information
NPI: 1720847148
Provider Name (Legal Business Name): CENTRAL FLORIDA HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1190 E CHURCH ST
BARTOW FL
33830-4117
US
IV. Provider business mailing address
47 5TH ST NW
WINTER HAVEN FL
33881-4672
US
V. Phone/Fax
- Phone: 866-234-8534
- Fax: 863-291-5128
- Phone: 866-234-8534
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANN
CLAUSSEN
Title or Position: CEO
Credential:
Phone: 863-291-5110