NPIMap

Organization Active NPI

Central Florida Health Care, Inc.

Doing business as Central Florida Health Care - Avon Park

  • Federally Qualified Health Center (FQHC)
  • Avon Park, FL
National Provider Identifier
1063409290
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL FLORIDA HEALTH CARE, INC.
Doing business as
Central Florida Health Care - Avon Park
Practice address
950 County Road 17a West
Avon Park, FL 33825-2164
Phone
(863) 452-3000
Fax
(963) 452-3069
NPI assigned
Oct 3, 2005
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL FLORIDA HEALTH CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ann Claussen
Title
Ceo
Phone
(863) 291-5110

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
General Practice Dentistry 1223G0001X
General Practice Physician 208D00000X

Addresses

Primary practice location

950 County Road 17a West
Avon Park, FL 33825-2164

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 291-5110

Other identifiers 2

IdentifierTypeStateIssuer
101847OtherFLMEDICARE FQHC
029549304OtherFLMEDCAID FQHC

Other names 1

  • Central Florida Health Care - Avon Park Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000228 FL Part B Supplier - Clinic/Group Practice 0143127951 Receives reassigned benefits from 157 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakeland, FL; Winter Haven, FL; Wauchula, FL; Mulberry, FL; Lake Wales, FL; Avon Park, FL; Davenport, FL; Dundee, FL…
O20101006000217 FL Part A Provider - Federally Qualified Health Center (FQHC) 0143127951 Practice locations: Avon Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063409290. Details of each certification follow.

Federally qualified health center certification: CCN 101847

Legal name
CENTRAL FLORIDA HEALTH CARE INC
Doing business as
CENTRAL FLORIDA HEALTH CARE, INC.-AVON PARK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 5, 1973 in FL
Enrollment address
950 County Road 17a W
Avon Park, FL 33825-2164

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Lake Avenue Medical Cen87 organizations share this tax ID, including this one
Part of
Lake Avenue Medical Cen

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

916 Dundee Rd
Dundee, FL 33838
Phone (863) 419-3330

106 NW 9th Ave
Mulberry, FL 33860
Phone (863) 425-6200

1514 1st St N
Winter Haven, FL 33881
Phone (863) 292-4280

201 Magnolia Ave SW
Winter Haven, FL 33880
Phone (863) 229-7950

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joyce Evers Individual Corporate DirectorBoard of Directors- Secretary Nov 18, 2014
Jennings Brinson Individual Corporate DirectorBoard of Directors- Vice Chairman Aug 11, 2017
Tina Solomon Individual Corporate OfficerChief Financial Officer Apr 15, 2019
Cara Roseanne Nelson-James Individual Corporate OfficerChief Clinical Officer Dec 1, 2019
Nicholas a Emanuel Individual Corporate DirectorBoard Member May 27, 2008
Ann M Claussen Individual Corporate DirectorCeo Jan 1, 2014
W-2 Managing EmployeeCeo Jan 1, 2014
Operational/Managerial ControlCeo Jan 1, 2014
Melissa Thibodeau Individual Corporate DirectorBoard of Directors- Treasurer Jun 26, 2017
Karen McKenzie Individual Corporate OfficerChief Dental Officer Jan 8, 2021
Lawrence Best Individual Corporate OfficerChief Operating Officer Jul 25, 2017
Andrew N Hein Individual Corporate OfficerChief Clinical Informatics Officer Jul 1, 2012
Barbara Turner Individual Corporate OfficerChief Quality Officer May 5, 2014
Philip Kenney Individual Corporate OfficerChief Human Resources Officer Jan 11, 2016

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Central Florida Health Care, Inc.-FrostproofFrostproof, FL, CCN 101851 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1994
Central Florida Health Care IncWinter Haven, FL, CCN 681068 Federally qualified health center 5% Or Greater Direct Ownership Interest Sep 30, 2016
Central Florida Health Care IncDundee, FL, CCN 681065 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2020
Central Florida Health Care IncLake Wales, FL, CCN 681066 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 1, 2016
Central Florida Health Care IncLakeland, FL, CCN 681178 Federally qualified health center 5% Or Greater Direct Ownership Interest May 11, 2020
Central Florida Health Care IncDavenport, FL, CCN 691010 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Central Florida Health Care IncBartow, FL, CCN C11021 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 2, 2024

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 88

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 88

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1063409290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "863-291-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 17A WEST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252164",
            "telephone_number": "863-452-3000",
            "fax_number": "963-452-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL FLORIDA HEALTH CARE INC",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "CLAUSSEN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-291-5110"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "101847",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCAID FQHC",
            "identifier": "029549304",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Florida Health Care - Avon Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Florida Health Care - Avon Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon Park, FL

Sources for this page

Verify at the official NPI Registry.