Healthcare Provider Details

I. General information

NPI: 1346963725
Provider Name (Legal Business Name): FLORIDA COMMUNITY ADVOCATES CENTRAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 E FORT KING ST
OCALA FL
34471-2235
US

IV. Provider business mailing address

13240 N CLEVELAND AVE STE 7
N FORT MYERS FL
33903-4855
US

V. Phone/Fax

Practice location:
  • Phone: 772-206-6142
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JIMMY PAGE
Title or Position: MANAGER
Credential:
Phone: 772-206-6142