Healthcare Provider Details

I. General information

NPI: 1346214491
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 W WASHINGTON ST
MONTICELLO FL
32344-1128
US

IV. Provider business mailing address

1255 W WASHINGTON ST
MONTICELLO FL
32344-1128
US

V. Phone/Fax

Practice location:
  • Phone: 850-342-0170
  • Fax: 850-342-0257
Mailing address:
  • Phone: 850-342-0170
  • Fax: 850-342-0257

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: KIM BARNHILL
Title or Position: ADMINISTRATOR
Credential:
Phone: 850-342-0170