Provider Demographics
NPI:1255005476
Name:CENTRAL FLORIDA FAMILY HEALTH CENTER INC.
Entity Type:Organization
Organization Name:CENTRAL FLORIDA FAMILY HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:ALYCEE
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-322-8645
Mailing Address - Street 1:4930 E LAKE MARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5003
Mailing Address - Country:US
Mailing Address - Phone:407-322-8645
Mailing Address - Fax:407-269-8986
Practice Address - Street 1:225 HARVEST TIME DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8814
Practice Address - Country:US
Practice Address - Phone:407-322-8645
Practice Address - Fax:407-269-8986
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL FLORIDA FAMILY HEALTH CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)