Healthcare Provider Details

I. General information

NPI: 1932368784
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: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 N MISSOURI AVE
LAKELAND FL
33805-4411
US

IV. Provider business mailing address

47 5TH ST NW
WINTER HAVEN FL
33881-4672
US

V. Phone/Fax

Practice location:
  • Phone: 863-413-8600
  • Fax: 863-413-8651
Mailing address:
  • Phone: 863-291-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANN CLAUSSEN
Title or Position: CEO
Credential:
Phone: 863-291-5110