Healthcare Provider Details
I. General information
NPI: 1720247588
Provider Name (Legal Business Name): CENTRAL FLORIDA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2008
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
916 DUNDEE RD
DUNDEE FL
33838-4198
US
IV. Provider business mailing address
47 5TH ST NW
WINTER HAVEN FL
33881-4672
US
V. Phone/Fax
- Phone: 863-419-3330
- Fax: 863-419-8651
- Phone: 863-291-5110
- 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