Provider Demographics
NPI:1851751549
Name:CENTRAL FLORIDA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CENTRAL FLORIDA HEALTH CARE, INC.
Other - Org Name:CENTRAL FLORIDA HEALTH CARE, INC. - LAKELAND PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-291-5110
Mailing Address - Street 1:47 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4672
Mailing Address - Country:US
Mailing Address - Phone:863-291-5110
Mailing Address - Fax:863-291-5128
Practice Address - Street 1:601 S FLORIDA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5237
Practice Address - Country:US
Practice Address - Phone:863-688-0841
Practice Address - Fax:863-616-9709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL FLORIDA HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-24
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)