Provider Demographics
NPI:1720826035
Name:FLORIDA COMMUNITY HEALTH PARTNERS
Entity type:Organization
Organization Name:FLORIDA COMMUNITY HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-769-4369
Mailing Address - Street 1:8140 COLLEGE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-5189
Mailing Address - Country:US
Mailing Address - Phone:239-202-8128
Mailing Address - Fax:239-237-5659
Practice Address - Street 1:5231 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6302
Practice Address - Country:US
Practice Address - Phone:239-202-8128
Practice Address - Fax:239-237-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty