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Organization

FLORIDA COMMUNITY HEALTH CENTERS INC

Active
Other names
Clewiston Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL F GERVASI D.O. (PRESIDENT & CEO)
(561) 844-9443
Entity
Organization

Contact information

Practice address
315 S W C OWEN AVE, CLEWISTON, FL 33440-3637
(863) 983-7813
(863) 983-9604
Mailing address
5827 CORPORATE WAY, WEST PALM BEACH, FL 33407-2000
(561) 844-9443
(561) 844-1013

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
207Q00000X
Family Medicine Physician
Primary
208000000X
Pediatrics Physician
261QF0400X
Federally Qualified Health Center (FQHC)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029574402
FL
05
060151900
FL
Enumeration date
05/10/2006
Last updated
06/17/2016
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