Provider Demographics
NPI:1669014296
Name:FAMILY SUPPORTIVE SERVICES OF CENTRAL FLORIDA, INC
Entity Type:Organization
Organization Name:FAMILY SUPPORTIVE SERVICES OF CENTRAL FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CBHCMS
Authorized Official - Phone:407-617-6438
Mailing Address - Street 1:3510 RODRICK CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4294
Mailing Address - Country:US
Mailing Address - Phone:407-617-6438
Mailing Address - Fax:
Practice Address - Street 1:7041 GRAND NATIONAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8381
Practice Address - Country:US
Practice Address - Phone:407-982-7718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management