Healthcare Provider Details

I. General information

NPI: 1073580890
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 SW 24TH STREET
FORT LAUDERDALE FL
33315-2643
US

IV. Provider business mailing address

780 SW 24TH STREET
FORT LAUDERDALE FL
33315-2643
US

V. Phone/Fax

Practice location:
  • Phone: 954-467-4700
  • Fax: 954-467-4704
Mailing address:
  • Phone: 954-467-4700
  • Fax: 954-467-4704

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: PAULA MICHELE THAQI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 954-467-4700