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General NPI Number Information
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NPI Number | 1679500490
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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 | 06/27/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2200 RINGLING BLVD
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City | SARASOTA
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State | FL
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Zip | 34237-6102
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Country | US
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Telephone | 941-861-2932
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Fax | 941-861-2945
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Provider Business Mailing Address
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Address Line | PO BOX 2658
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City | SARASOTA
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State | FL
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Zip | 34230-2658
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Country | US
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Telephone | 941-861-2932
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Fax | 941-861-2945
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHARLES ROBERT 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH8143
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License Number State | FL
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