Provider Demographics
NPI:1831286095
Name:EPILEPSY ASSOCIATION OF CENTRAL FLORIDA, INC.
Entity Type:Organization
Organization Name:EPILEPSY ASSOCIATION OF CENTRAL FLORIDA, INC.
Other - Org Name:EPILEPSY ASSOCIATION OF CENTRAL FLORIDA, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-422-1416
Mailing Address - Street 1:1221 W COLONIAL DR
Mailing Address - Street 2:#103
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7163
Mailing Address - Country:US
Mailing Address - Phone:407-422-1416
Mailing Address - Fax:407-423-0417
Practice Address - Street 1:1221 W COLONIAL DR
Practice Address - Street 2:#103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7163
Practice Address - Country:US
Practice Address - Phone:407-422-1416
Practice Address - Fax:407-423-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X, 251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251V00000XAgenciesVoluntary or Charitable