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General NPI Number Information
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NPI Number | 1154545085
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Entity Type | Organization
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Legal Business Name | SCHOOL BOARD OF BRADFORD CO FL
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 611 N ORANGE ST
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City | STARKE
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State | FL
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Zip | 32091-2434
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Country | US
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Telephone | 904-966-6815
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Fax | 904-966-6818
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Provider Business Mailing Address
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Address Line | 611 N ORANGE ST
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City | STARKE
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State | FL
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Zip | 32091-2434
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Country | US
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Telephone | 904-966-6815
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Fax | 904-966-6818
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Authorized Official
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Title or Position | MEDICAID FINANCE ASSISTANT
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Name | MRS. PATTI T PRIEST
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Credential |
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Telephone | 904-966-6815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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