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General NPI Number Information
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NPI Number | 1407828189
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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 | 02/06/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 2475 GARRISON AVE
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City | PORT ST JOE
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State | FL
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Zip | 32456-5265
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Country | US
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Telephone | 850-227-1276
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Fax | 850-227-1794
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Provider Business Mailing Address
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Address Line | 2475 GARRISON AVE
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City | PORT ST JOE
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State | FL
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Zip | 32456-5265
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Country | US
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Telephone | 850-227-1276
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Fax | 850-227-1794
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER/ADMINISTRAT
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Name | DOUGLAS MICHAEL KENT
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Credential | M.P.H.
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Telephone | 850-227-1276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 251K00000X
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License Number State | FL
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