MEDICARE: BATSON FAMILY HEALTH CENTER FOR WELLNESS,P.A.

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	261QP2300X	Primary Care Clinic/Center	ME 46662	FL

General Provider Information

NPI Number	:	1902353485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATSON FAMILY HEALTH CENTER FOR WELLNESS,P.A.

Provider Business Mailing Address
First Line	:	450 W STATE ROAD 434
Second Line	:	SUITE 2020
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5118
Country	:	US
Telephone Number	:	407-331-7079
Fax Number	:	407-331-4233

Provider Business Practice Location Address
First Line	:	450 W STATE ROAD 434
Second Line	:	SUITE 2020
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5118
Country	:	US
Telephone Number	:	407-331-7079
Fax Number	:	407-331-4233

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHARLES LEE BATSON
Credential	:	M.D.
Telephone Number	:	407-621-1056

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	09/01/2016

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