Organization
BRIDGE OF HOPE OF CENTRAL FLORIDA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA ROMAN BA (C.E.O.)
(407) 575-4636
Entity
Organization
Contact information
Practice address
1300 KEVSTIN DR, KISSIMMEE, FL 34744-5843
(407) 575-4636
(321) 250-7425
Mailing address
PO BOX 452878, KISSIMMEE, FL 34745-2878
(407) 575-4636
(407) 343-5599
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
SA 8292
FL
261QP2000X
Physical Therapy Clinic/Center
PT 24417
FL
261QX0100X
Occupational Medicine Clinic/Center
OT 11560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000867500
—
FL
05
—
000867501
—
FL
05
—
000867502
—
FL
05
—
000867503
—
FL
Enumeration date
11/01/2010
Last updated
08/19/2015
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