Provider Demographics
NPI:1477598167
Name:FAMILY HEALTH CARE OF CENTRAL FLORIDA, PA
Entity Type:Organization
Organization Name:FAMILY HEALTH CARE OF CENTRAL FLORIDA, PA
Other - Org Name:FAMILY PRACTICE ASSOCIATES MD, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-846-8600
Mailing Address - Street 1:461 WEST OAK STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-846-8600
Mailing Address - Fax:407-846-2301
Practice Address - Street 1:461 WEST OAK STREET
Practice Address - Street 2:SUITE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-846-8600
Practice Address - Fax:407-846-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036738207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047764800Medicaid
FL256651600Medicaid
FLK0545Medicare PIN
FL047764800Medicaid
FL256651600Medicaid