Healthcare Provider Details

I. General information

NPI: 1538293824
Provider Name (Legal Business Name): FLORIDA HEALTH CARE PLAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2777 ENTERPRISE RD
ORANGE CITY FL
32763-8310
US

IV. Provider business mailing address

2450 MASON AVE
DAYTONA BEACH FL
32114-5110
US

V. Phone/Fax

Practice location:
  • Phone: 386-774-5961
  • Fax: 386-774-7592
Mailing address:
  • Phone: 386-615-5008
  • Fax: 386-676-7165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License NumberPH23795
License Number StateFL

VIII. Authorized Official

Name: DR. CHRISTOPHER J SMITH
Title or Position: CMO
Credential:
Phone: 386-615-5008