Provider Demographics
NPI:1285923284
Name:BHI OF CENTRAL FLORIDA CORPORATION
Entity type:Organization
Organization Name:BHI OF CENTRAL FLORIDA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-847-3667
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-0413
Mailing Address - Country:US
Mailing Address - Phone:386-847-3667
Mailing Address - Fax:386-428-2351
Practice Address - Street 1:1869 INDIA PALM DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132
Practice Address - Country:US
Practice Address - Phone:386-847-3667
Practice Address - Fax:386-428-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1100004387343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)