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General NPI Number Information
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NPI Number | 1780478917
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Entity Type | Organization
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Legal Business Name | HUMANITARY MEDICAL CENTER WINTER HAVEN INC
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 205 1ST ST S STE 101
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3266
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Country | US
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Telephone | 813-499-1500
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Fax | 813-499-1499
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Provider Business Mailing Address
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Address Line | 3109 W DR MLK BLVD STE 121
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City | TAMPA
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State | FL
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Zip | 33607-6240
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Country | US
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Telephone | 813-468-1866
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Fax | 813-499-1499
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIECER GONZALEZ
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Credential |
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Telephone | 813-468-1866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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