Provider Demographics
NPI:1497221865
Name:MENTAL HEALTH OF CENTRAL FLORIDA, LLC
Entity Type:Organization
Organization Name:MENTAL HEALTH OF CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERRER HOPGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:787-637-2581
Mailing Address - Street 1:3819 SE 38TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-4942
Mailing Address - Country:US
Mailing Address - Phone:787-637-2581
Mailing Address - Fax:
Practice Address - Street 1:929 N US HIGHWAY 441 STE 102
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3002
Practice Address - Country:US
Practice Address - Phone:352-633-0473
Practice Address - Fax:352-775-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid