Provider Demographics
NPI:1568482347
Name:CHARLEE FAMILY CARE SERVICES OF CENTRAL FLORIDA, INC.
Entity Type:Organization
Organization Name:CHARLEE FAMILY CARE SERVICES OF CENTRAL FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:DRAD
Authorized Official - Phone:407-273-8444
Mailing Address - Street 1:11875 HIGH TECH AVE
Mailing Address - Street 2:S-200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1400
Mailing Address - Country:US
Mailing Address - Phone:407-273-8444
Mailing Address - Fax:407-273-9344
Practice Address - Street 1:11875 HIGH TECH AVE
Practice Address - Street 2:S-200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1400
Practice Address - Country:US
Practice Address - Phone:407-273-8444
Practice Address - Fax:407-273-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty