Healthcare Provider Details

I. General information

NPI: 1508949819
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 NW MILNER DR
PORT ST LUCIE FL
34983-3392
US

IV. Provider business mailing address

5150 NW MILNER DR
PORT ST LUCIE FL
34983-3392
US

V. Phone/Fax

Practice location:
  • Phone: 772-462-3800
  • Fax: 772-462-3865
Mailing address:
  • Phone: 772-468-3800
  • Fax: 772-871-5361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberME91352
License Number StateFL

VIII. Authorized Official

Name: MR. CLINT J SPERBER
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-462-3800