NPI Code Details Logo

NPI 1275203796

NPI 1275203796 : CENTRAL FLORIDA HEALTH CARE, INC. : DAVENPORT, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1275203796
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CENTRAL FLORIDA HEALTH CARE, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/16/2021
-----------------------------------------------------
    Last Update Date     |    05/15/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    130 RIDGE CENTER DR 
-----------------------------------------------------
    City                 |    DAVENPORT
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33837-6413
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    866-234-8534
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    47 5TH ST NW 
-----------------------------------------------------
    City                 |    WINTER HAVEN
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33881-4672
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    866-234-8534
-----------------------------------------------------
    Fax                  |    863-837-4469
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     ANN  CLAUSSEN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    863-291-5110
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1223G0001X
-----------------------------------------------------
    Taxonomy Name        |    General Practice Dentistry
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QM1300X
-----------------------------------------------------
    Taxonomy Name        |    Multi-Specialty Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.