Active NPI
Humanitary Medical Center Winter Haven Inc
- Primary Care Clinic/Center
- Winter Haven, FL
National Provider Identifier
1780478917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2325878 | Humanitary Medical Center Winter Haven Inc | Certificate of waiver | Jun 22, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Winter Haven, FL
- NPI 1497362842
-
- Family Nurse Practitioner
- Brandon, FL
- NPI 1225863186
-
- Psychiatric/Mental Health Nurse Practitioner
- Tampa, FL
- NPI 1699453183
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.