Healthcare Provider Details

I. General information

NPI: 1629079900
Provider Name (Legal Business Name): NORTH FLORIDA RESPIRATORY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SHADEVILLE RD
CRAWFORDVILLE FL
32327-2316
US

IV. Provider business mailing address

PO BOX 1635
CRAWFORDVILLE FL
32326-1635
US

V. Phone/Fax

Practice location:
  • Phone: 859-926-7122
  • Fax: 850-926-9766
Mailing address:
  • Phone: 859-926-7122
  • Fax: 850-926-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number280
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number01847
License Number StateFL

VIII. Authorized Official

Name: MRS. VICKIE DIANNE BROWN
Title or Position: OWNER
Credential: CRT
Phone: 850-926-7122