Central Florida Health Care Inc
Organization Active NPI Optometrist · Haines City, FL
NPI 1396205779 · NPPES record last updated Mar 22, 2019
Key facts
- NPI
- 1396205779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- CENTRAL FLORIDA HEALTH CARE INC
- Practice address
- 705 Ingraham Ave
Haines City, FL 33844-4327 - Phone
- (863) 438-6900
- NPI assigned
- Mar 22, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTRAL FLORIDA HEALTH CARE INC
Authorized official
- Name
- Tamara Treadway
- Title
- Managed Care Supervisor / Credentia
- Phone
- (863) 268-7850
Other NPIs on the same Medicare enrollment 20
Corporate family (same tax ID) 24
Practitioners 3
-
Adam M McKinnon Sr., APRN, FNP-C
-
Jacob Matthew Mearse, DNP, CNM, PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
- Tax ID family
- Central Fla HLTH Care L
- Part of
- Central Fla HLTH Care L
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
705 Ingraham Ave
Haines City, FL 33844-4327
Mailing address
47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 268-7850
Other providers in Haines City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.