| Central Florida Health Care-lakeland Primary Care | |
|
1129 N Missouri Ave Lakeland FL 33805-4411 | |
| (863) 413-8600 | |
| (863) 413-8651 |
| Full Name | Central Florida Health Care-lakeland Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1129 N Missouri Ave, Lakeland, Florida |
| Authorized Official Name and Position | Ann Claussen (CEO) |
| Authorized Official Contact | 8632915110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Florida Health Care-lakeland Primary Care 47 5th St Nw Winter Haven FL 33881-4672 Ph: (863) 291-5110 | Central Florida Health Care-lakeland Primary Care 1129 N Missouri Ave Lakeland FL 33805-4411 Ph: (863) 413-8600 |
| NPI Number | 1386835064 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 01/25/2019 |
| Medicare PECOS PAC ID | 0143127951 |
|---|---|
| Medicare Enrollment ID | O20091009000299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386835064 | NPI | - | NPPES |
| 101032 | Other | FL | MEDICARE FQHC |
| 691835202 | Other | FL | MEDICAID FQHC |
| 77069I | Other | FL | MEDICARE FFS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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