Organization Active NPI

Humanitary Medical Center Winter Haven Inc

  • Primary Care Clinic/Center
  • Winter Haven, FL
National Provider Identifier
1780478917
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HUMANITARY MEDICAL CENTER WINTER HAVEN INC
Practice address
205 1St St S Ste 101
Winter Haven, FL 33880-3266
Phone
(813) 499-1500
Fax
(813) 499-1499
NPI assigned
Apr 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Eliecer Gonzalez
Title
President
Phone
(813) 468-1866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

205 1St St S Ste 101
Winter Haven, FL 33880-3266

Mailing address

3109 W Dr MLK Blvd Ste 121
Tampa, FL 33607-6240
Phone (813) 468-1866

Other names 1

  • Humanitary Medical Center Winter Haven Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250922003255 FL Part B Supplier - Clinic/Group Practice 0840795845 Receives reassigned benefits from 2 practitioners
Practice locations: Winter Haven, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2325878Humanitary Medical Center Winter Haven Inc205 1St Street S, Winter Haven, FL 33880Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1780478917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 W DR MLK BLVD STE 121",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076240",
            "telephone_number": "813-468-1866",
            "fax_number": "813-499-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 1ST ST S STE 101",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803266",
            "telephone_number": "813-499-1500",
            "fax_number": "813-499-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANITARY MEDICAL CENTER WINTER HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ELIECER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-468-1866"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humanitary Medical Center Winter Haven Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.