Healthcare Provider Details

I. General information

NPI: 1336059906
Provider Name (Legal Business Name): ADVENTHEALTH POLK NORTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6945 CYPRESS GARDENS BLVD
WINTER HAVEN FL
33884-3572
US

IV. Provider business mailing address

PO BOX 947372
ATLANTA GA
30394-7372
US

V. Phone/Fax

Practice location:
  • Phone: 863-852-2580
  • Fax: 863-852-2595
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ALAN JUSTIN HENGESBACH
Title or Position: CFO
Credential:
Phone: 863-419-2260