Organization
FLORIDA COMMUNITY HEALTH CENTERS INC
Active
Other names
Indiantown 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
15858 S.W. WARFIELD BLVD., INDIANTOWN, FL 34956-0648
(772) 597-3596
(772) 597-4194
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
—
029574403
—
FL
05
—
060144600
—
FL
Enumeration date
05/11/2006
Last updated
06/17/2016
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