=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720153984
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITRUS SCHOOL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2006
-----------------------------------------------------
Last Update Date | 02/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1007 W MAIN ST
-----------------------------------------------------
City | INVERNESS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34450-4625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-729-1931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1007 W MAIN ST
-----------------------------------------------------
City | INVERNESS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34450-4625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-729-1931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAID COORDINATOR
-----------------------------------------------------
Name | TAMARA GENT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-726-1931
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | 251300000X
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------