Provider Demographics
NPI:1962686725
Name:INDEPENDENCE INC. OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:INDEPENDENCE INC. OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-688-4343
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33846-0605
Mailing Address - Country:US
Mailing Address - Phone:863-688-4343
Mailing Address - Fax:863-688-4322
Practice Address - Street 1:6494 OAKPOINT DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-5402
Practice Address - Country:US
Practice Address - Phone:863-944-9262
Practice Address - Fax:863-688-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL679999096251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services