Healthcare Provider Details

I. General information

NPI: 1295919132
Provider Name (Legal Business Name): FLORIDA COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 US HIGHWAY 27 STE 1
MOORE HAVEN FL
33471
US

IV. Provider business mailing address

406 N. ALEXANDER STREET
PLANT CITY FL
33563-4603
US

V. Phone/Fax

Practice location:
  • Phone: 863-808-1272
  • Fax: 561-282-0591
Mailing address:
  • Phone: 863-808-1272
  • Fax: 561-282-0591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAIDEE PRENIL ADEYEMO
Title or Position: PRESIDENT
Credential: BSN
Phone: 863-808-1272