Healthcare Provider Details

I. General information

NPI: 1346729068
Provider Name (Legal Business Name): CENTRAL FLORIDA HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
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: 863-229-7950
  • Fax:
Mailing address:
  • Phone: 863-268-7850
  • Fax: 863-268-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: TAMARA TREADWAY
Title or Position: MANAGED CARE SUPERVISOR
Credential:
Phone: 863-268-7850