Healthcare Provider Details

I. General information

NPI: 1013984863
Provider Name (Legal Business Name): FLORIDA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 SE WILLOUGHBY BLVD
STUART FL
34994-5060
US

IV. Provider business mailing address

3441 SE WILLOUGHBY BLVD
STUART FL
34994-5060
US

V. Phone/Fax

Practice location:
  • Phone: 772-221-4000
  • Fax: 772-221-4989
Mailing address:
  • Phone: 772-221-4000
  • Fax: 772-221-4989

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: KARLETTE J PECK
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-221-4000