Healthcare Provider Details

I. General information

NPI: 1760841159
Provider Name (Legal Business Name): CENTRAL FLORIDA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MAGNOLIA AVE SW
WINTER HAVEN FL
33880-2943
US

IV. Provider business mailing address

47 5TH ST NW
WINTER HAVEN FL
33881-4672
US

V. Phone/Fax

Practice location:
  • Phone: 863-292-4280
  • Fax: 863-292-4293
Mailing address:
  • Phone: 863-291-5110
  • Fax: 863-291-5124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ANN CLAUSSEN
Title or Position: CEO
Credential:
Phone: 863-291-5110