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1011 E Main St Haines City FL 33844-4239 | |
| (866) 234-8534 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1011 E Main St, Haines City, Florida |
| Authorized Official Name and Position | Ann Claussen (CEO) |
| Authorized Official Contact | 8632915110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
47 5th St Nw Winter Haven FL 33881-4672 Ph: (863) 291-5110 | 1011 E Main St Haines City FL 33844-4239 Ph: (866) 234-8534 |
| NPI Number | 1780194928 |
|---|---|
| Provider Enumeration Date | 10/02/2017 |
| Last Update Date | 01/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780194928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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