Healthcare Provider Details

I. General information

NPI: 1932246501
Provider Name (Legal Business Name): HEALTH SPECIALISTS OF CENTRAL FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 TURKEY LAKE RD SUITE 1-1
ORLANDO FL
32819-7218
US

IV. Provider business mailing address

6900 TURKEY LAKE RD SUITE 1-1
ORLANDO FL
32819-7218
US

V. Phone/Fax

Practice location:
  • Phone: 407-370-9783
  • Fax: 407-370-9784
Mailing address:
  • Phone: 407-370-9783
  • Fax: 407-370-9784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME-75691
License Number StateFL

VIII. Authorized Official

Name: MS. WENDY S PACKER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 407-370-9783