Healthcare Provider Details

I. General information

NPI: 1285806224
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SW 16TH AVE BLDG B
GAINESVILLE FL
32608-1153
US

IV. Provider business mailing address

1515 E SILVER SPRINGS BLVD
OCALA FL
34470-6831
US

V. Phone/Fax

Practice location:
  • Phone: 352-334-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MS. CATHY KEATHLEY
Title or Position: PROGRAM ADMINISTRATOR
Credential:
Phone: 352-334-1400