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General NPI Number Information
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NPI Number | 1013324235
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Entity Type | Organization
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Legal Business Name | FLORIDA DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1750 17TH ST BLDG E
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City | SARASOTA
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State | FL
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Zip | 34234-8632
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Country | US
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Telephone | 941-861-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 17TH ST BLDG E
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City | SARASOTA
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State | FL
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Zip | 34234-8632
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Country | US
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Telephone | 941-861-1424
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHARLES HENRY
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Credential |
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Telephone | 941-861-2950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH 28273
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License Number State | FL
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