Healthcare Provider Details

I. General information

NPI: 1023210853
Provider Name (Legal Business Name): FLORIDA COMMUNITY HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 DELAWARE AVE
FORT PIERCE FL
34950-3975
US

IV. Provider business mailing address

5827 CORPORATE WAY
WEST PALM BEACH FL
33407-2000
US

V. Phone/Fax

Practice location:
  • Phone: 772-461-1402
  • Fax: 772-252-7114
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-844-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DR. WILHELMINA N LEWIS
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 561-844-9443