Healthcare Provider Details

I. General information

NPI: 1801341888
Provider Name (Legal Business Name): CENTRAL FLORIDA YOUNG MEN'S CHRISTIAN ASSOCIATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N MILLS AVE
ORLANDO FL
32803-5721
US

IV. Provider business mailing address

433 N MILLS AVE
ORLANDO FL
32803-5798
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-9220
  • Fax: 407-896-4247
Mailing address:
  • Phone: 407-896-9220
  • Fax: 407-896-4247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN MANAHAN
Title or Position: CHIEF FINANCIAL OFFICE
Credential:
Phone: 407-896-9229