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NPI Code Detail

MEDICARE: STATE OF FLORIDA DEPARTMENT OF HEALTH

MEDICARE: STATE OF FLORIDA DEPARTMENT OF HEALTH
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
1251K00000XPublic Health or Welfare Agency

General Provider Information

NPI Number : 1376617654
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF FLORIDA DEPARTMENT OF HEALTH
Provider Business Mailing Address
First Line : PO BOX 847
Second Line : 301 S LEMON STREET
City : BUNNELL
State : FL
Zip : 32110-0847
Country : US
Telephone Number : 386-437-7350
Fax Number : 386-437-7353
Provider Business Practice Location Address
First Line : 301 S LEMON ST
Second Line :
City : BUNNELL
State : FL
Zip : 32110-6212
Country : US
Telephone Number : 386-437-7350
Fax Number : 386-437-7353
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. PATRICK JOHNSON
Credential : R.N.
Telephone Number : 386-437-7350
Provider Enumeration Date : 11/20/2006
Last Update Date : 08/22/2020

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Directions to “STATE OF FLORIDA DEPARTMENT OF HEALTH ” Practice Location

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