Healthcare Provider Details

I. General information

NPI: 1932149531
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19611 STATE ROAD 20 WEST
BLOUNTSTOWN FL
32424-3917
US

IV. Provider business mailing address

19611 STATE ROAD 20 WEST
BRISTOL FL
32321-6917
US

V. Phone/Fax

Practice location:
  • Phone: 850-674-5645
  • Fax: 850-674-5420
Mailing address:
  • Phone: 850-643-2415
  • Fax: 850-643-5689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. HEATHER N ELLERBEE
Title or Position: SENIOR PUBLIC HEALTH SERVICES MANAG
Credential:
Phone: 850-214-5006