Healthcare Provider Details

I. General information

NPI: 1205927514
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E JAMES LEE BLVD
CRESTVIEW FL
32539-3118
US

IV. Provider business mailing address

221 HOSPITAL DR NE
FORT WALTON BEACH FL
32548-5066
US

V. Phone/Fax

Practice location:
  • Phone: 850-689-7855
  • Fax: 850-689-7872
Mailing address:
  • Phone: 850-833-9240
  • Fax: 850-833-9252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. KAREN A CHAPMAN
Title or Position: DIRECTOR
Credential: MD,MPH
Phone: 850-833-9233