Healthcare Provider Details

I. General information

NPI: 1538369251
Provider Name (Legal Business Name): CENTRAL FLORIDA HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 LAKELAND HILLS BLVD
LAKELAND FL
33805-3016
US

IV. Provider business mailing address

1729 LAKELAND HILLS BLVD
LAKELAND FL
33805-3016
US

V. Phone/Fax

Practice location:
  • Phone: 863-686-0082
  • Fax: 863-686-2893
Mailing address:
  • Phone: 863-686-0082
  • Fax: 863-686-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: BERNARD FULSE
Title or Position: CFO
Credential:
Phone: 863-452-3060