Provider Demographics
NPI:1801037882
Name:MEDICAL CARE FOR CENTRAL FLORIDA INC
Entity Type:Organization
Organization Name:MEDICAL CARE FOR CENTRAL FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-467-1029
Mailing Address - Street 1:107 NW 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2837
Mailing Address - Country:US
Mailing Address - Phone:863-467-1029
Mailing Address - Fax:863-248-8172
Practice Address - Street 1:107 NW 11TH AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2837
Practice Address - Country:US
Practice Address - Phone:863-467-1029
Practice Address - Fax:863-248-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty