MEDICARE: CENTRAL FLORIDA HEALTH CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720247588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	47 5TH ST NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4672
Country	:	US
Telephone Number	:	863-291-5110
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 DUNDEE RD
Second Line	:
City	:	DUNDEE
State	:	FL
Zip	:	33838-4198
Country	:	US
Telephone Number	:	863-419-3330
Fax Number	:	863-419-8651

Authorized Official
Title or Position	:	CEO
Name	:	ANN CLAUSSEN
Credential	:
Telephone Number	:	863-291-5110

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	03/15/2019

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