Provider Demographics
NPI:1922017011
Name:HOUSTON OF FLORIDA, INC.
Entity Type:Organization
Organization Name:HOUSTON OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:W.
Authorized Official - Middle Name:HOUSTON
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:407-656-4015
Mailing Address - Street 1:1780 CROWN POINT WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3700
Mailing Address - Country:US
Mailing Address - Phone:407-656-4015
Mailing Address - Fax:407-656-4879
Practice Address - Street 1:1780 CROWN POINT WOODS CIR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3700
Practice Address - Country:US
Practice Address - Phone:407-656-4015
Practice Address - Fax:407-656-4879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP479762363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2689Medicare ID - Type UnspecifiedGROUP NUMBER
FLY4155YMedicare PIN