Healthcare Provider Details
I. General information
NPI: 1619225067
Provider Name (Legal Business Name): HEALTH GROUP CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2012
Last Update Date: 09/02/2025
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 N 6TH ST
HAINES CITY FL
33844-4207
US
IV. Provider business mailing address
141 N 6TH ST
HAINES CITY FL
33844-4207
US
V. Phone/Fax
- Phone: 407-201-7918
- Fax: 863-438-6624
- Phone: 863-353-1538
- Fax: 863-438-6624
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QC1800X |
| Taxonomy | Corporate Health Clinic/Center |
| License Number | HCC10049 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
JAIME
JORGE-FLORES
Title or Position: CEO
Credential: M.D.
Phone: 407-267-8823