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General NPI Number Information
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NPI Number | 1417298761
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Entity Type | Organization
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Legal Business Name | FLORIDA DOH
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 205 DR MARTIN LUTHER KING JR ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3109
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Country | US
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Telephone | 727-824-6900
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Fax | 727-820-4275
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Provider Business Mailing Address
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Address Line | 205 DR MARTIN LUTHER KING JR ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3109
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Country | US
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Telephone | 727-824-6900
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Fax | 727-820-4275
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DHARAMRAJ CLAUDE
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Credential | M.D.
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Telephone | 727-824-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number | ME0037797
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License Number State | FL
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