Healthcare Provider Details

I. General information

NPI: 1962082834
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19108 E COLONIAL DR
ORLANDO FL
32820-3701
US

IV. Provider business mailing address

110 S WOODLAND ST
WINTER GARDEN FL
34787-3546
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-8827
  • Fax: 321-221-2043
Mailing address:
  • Phone: 407-905-8827
  • Fax: 321-221-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARICRUZ NIEVES
Title or Position: DIRECTOR OF BILLING & MANAGED CARE
Credential:
Phone: 407-905-8827