Organization
CENTRAL FLORIDA HEALTH CARE, INC.
Active
Parent organization
CENTRAL FLORIDA HEALTH CARE INC
Other names
Central Florida Health Care-Lakeland Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL FLORIDA HEALTH CARE INC
Authorized official
ANN CLAUSSEN (CEO)
(863) 291-5110
Entity
Organization
Contact information
Practice address
1129 N MISSOURI AVE, LAKELAND, FL 33805-4411
(863) 413-8600
(863) 413-8651
Mailing address
47 5TH ST NW, WINTER HAVEN, FL 33881-4672
(863) 291-5110
(863) 291-5124
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101032
MEDICARE FQHC
FL
01
—
691835202
MEDICAID FQHC
FL
01
—
77069I
MEDICARE FFS
FL
Enumeration date
08/07/2007
Last updated
01/25/2019
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