Healthcare Provider Details

I. General information

NPI: 1639226129
Provider Name (Legal Business Name): CHILDREN'S HOME SOCIETY OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 23RD ST STE E40
PANAMA CITY FL
32405-3936
US

IV. Provider business mailing address

5768 S SEMORAN BLVD
ORLANDO FL
32822-4818
US

V. Phone/Fax

Practice location:
  • Phone: 321-397-3000
  • Fax:
Mailing address:
  • Phone: 321-397-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANDRY SWEET
Title or Position: CEO
Credential:
Phone: 321-397-3000