MEDICARE: SCHOOL BOARD OF BRADFORD CO FL

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	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336090828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL BOARD OF BRADFORD CO FL

Provider Business Mailing Address
First Line	:	501 W WASHINGTON ST
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-2525
Country	:	US
Telephone Number	:	904-966-6018
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 W WASHINGTON ST
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-2525
Country	:	US
Telephone Number	:	904-966-6018
Fax Number	:

Authorized Official
Title or Position	:	DATA SCIENTIST
Name	:	EVELYN CHASTAIN
Credential	:
Telephone Number	:	904-966-6035

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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