Healthcare Provider Details

I. General information

NPI: 1659645448
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2012
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 AVENUE P
RIVIERA BEACH FL
33404-7258
US

IV. Provider business mailing address

800 CLEMATIS ST
WEST PALM BEACH FL
33401-5107
US

V. Phone/Fax

Practice location:
  • Phone: 561-671-4117
  • Fax: 561-837-5202
Mailing address:
  • Phone: 561-671-4117
  • Fax: 561-837-5202

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: ALINA M ALONSO
Title or Position: DIRECTOR
Credential: M.D.
Phone: 561-671-4003