Provider Demographics
NPI:1245652221
Name:AMERICAN CARE OF NORTH FLORIDA, INC
Entity type:Organization
Organization Name:AMERICAN CARE OF NORTH FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER SERVICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AGUEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-278-0200
Mailing Address - Street 1:11255 SW 211TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2240
Mailing Address - Country:US
Mailing Address - Phone:305-278-0200
Mailing Address - Fax:786-235-0145
Practice Address - Street 1:502 E HINSON AVE
Practice Address - Street 2:DOWNTOWN HAINES CITY MEDICAL CENTER
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-5240
Practice Address - Country:US
Practice Address - Phone:863-421-5500
Practice Address - Fax:863-421-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53888208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty