Healthcare Provider Details

I. General information

NPI: 1710949318
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 SCENIC CIRCLE
BONIFAY FL
32425
US

IV. Provider business mailing address

603 SCENIC CIRCLE DR
BONIFAY FL
32425-3060
US

V. Phone/Fax

Practice location:
  • Phone: 850-547-8500
  • Fax: 850-547-8515
Mailing address:
  • Phone: 850-547-8500
  • Fax: 850-547-8515

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. TRACI CORBIN
Title or Position: ADMINISTRATOR
Credential: DNP
Phone: 850-614-6060