Healthcare Provider Details

I. General information

NPI: 1215906938
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 HEALTH PARK DR
MOORE HAVEN FL
33471-6206
US

IV. Provider business mailing address

PO BOX 489
MOORE HAVEN FL
33471-0489
US

V. Phone/Fax

Practice location:
  • Phone: 863-946-0707
  • Fax: 863-946-3097
Mailing address:
  • Phone: 863-946-0707
  • Fax: 863-946-3097

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: MICHAEL GLEN TOMES
Title or Position: ADMINISTRATIVE SERVICES DIRECTOR 1
Credential:
Phone: 863-674-4041