MEDICARE: FLORIDA HEALTH CARE PLAN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336M0003X	Managed Care Organization Pharmacy	PH23786	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2004146	OTHER		PK

General Provider Information

NPI Number	:	1255465605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA HEALTH CARE PLAN INC

Provider Business Mailing Address
First Line	:	2450 MASON AVE
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-5110
Country	:	US
Telephone Number	:	386-615-5008
Fax Number	:	386-676-7165

Provider Business Practice Location Address
First Line	:	937 N SPRING GARDEN AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-2560
Country	:	US
Telephone Number	:	386-736-7318
Fax Number	:	386-943-8123

Authorized Official
Title or Position	:	CMO
Name	:	DR. CHRISTOPHER J. SMITH
Credential	:
Telephone Number	:	386-615-5008

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	04/22/2025

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Directions to “FLORIDA HEALTH CARE PLAN INC ” Practice Location

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