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1501-1507 Bill Beck Blvd Kissimmee FL 34744 | |
| (407) 943-8600 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1501-1507 Bill Beck Blvd, Kissimmee, Florida |
| Authorized Official Name and Position | Belinda Johnson-cornett (CEO) |
| Authorized Official Contact | 4079438600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1877 Fortune Rd Kissimmee FL 34744-4428 Ph: (407) 943-8600 | 1501-1507 Bill Beck Blvd Kissimmee FL 34744 Ph: (407) 943-8600 |
| NPI Number | 1043873342 |
|---|---|
| Provider Enumeration Date | 04/22/2019 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043873342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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