Healthcare Provider Details
I. General information
NPI: 1073871885
Provider Name (Legal Business Name): HEART OF FLORIDA HEALTH CENTER-THE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2012
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1025 SW 1ST AVE
OCALA FL
34471-0900
US
IV. Provider business mailing address
1025 SW 1ST AVE
OCALA FL
34471-0900
US
V. Phone/Fax
- Phone: 352-732-6599
- Fax: 352-732-4816
- Phone: 352-732-6599
- Fax: 352-732-4816
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
CLAY
Title or Position: CEO
Credential:
Phone: 352-732-6599