Provider Demographics
NPI:1295919132
Name:FLORIDA COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:FLORIDA COMMUNITY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAIDEE
Authorized Official - Middle Name:PRENIL
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:863-808-1272
Mailing Address - Street 1:406 N. ALEXANDER STREET
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4603
Mailing Address - Country:US
Mailing Address - Phone:863-808-1272
Mailing Address - Fax:561-282-0591
Practice Address - Street 1:691 US HIGHWAY 27
Practice Address - Street 2:STE 1
Practice Address - City:MOORE HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33471
Practice Address - Country:US
Practice Address - Phone:863-808-1272
Practice Address - Fax:561-282-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service