Healthcare Provider Details

I. General information

NPI: 1982248134
Provider Name (Legal Business Name): HEART OF FLORIDA HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

IV. Provider business mailing address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

V. Phone/Fax

Practice location:
  • Phone: 352-877-7318
  • Fax:
Mailing address:
  • Phone: 352-732-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW CLAY
Title or Position: CEO
Credential:
Phone: 352-732-6599