Healthcare Provider Details

I. General information

NPI: 1679158604
Provider Name (Legal Business Name): HEART & LIFE COMMUNITY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N MAGNOLIA AVE STE 409
ORLANDO FL
32803-3861
US

IV. Provider business mailing address

801 N MAGNOLIA AVE STE 409
ORLANDO FL
32803-3861
US

V. Phone/Fax

Practice location:
  • Phone: 321-655-5554
  • Fax: 407-264-8254
Mailing address:
  • Phone: 321-655-5554
  • Fax: 407-264-8254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ODALYS DUARTE
Title or Position: PRESIDENT
Credential:
Phone: 321-655-5554