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General NPI Number Information
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NPI Number | 1184659450
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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 | 07/12/2006
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1217 N PEARL ST
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City | JACKSONVILLE
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State | FL
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Zip | 32202-3926
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Country | US
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Telephone | 904-791-1690
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Fax | 904-791-1626
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Provider Business Mailing Address
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Address Line | 50 W MAXWELL ST
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City | PENSACOLA
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State | FL
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Zip | 32501-1759
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Country | US
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Telephone | 850-595-8895
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Fax |
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Authorized Official
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Title or Position | PENSACOLA LAB DIRECTOR
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Name | DR. JOHN W. PARKER
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Credential |
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Telephone | 850-595-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | FL
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