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General NPI Number Information
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NPI Number | 1780650879
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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 | 02/27/2006
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 115 K D REVELL RD
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City | WAUCHULA
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State | FL
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Zip | 33873
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Country | US
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Telephone | 863-773-4161
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Fax | 863-773-0978
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Provider Business Mailing Address
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Address Line | 115 K D REVELL RD
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City | WAUCHULA
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State | FL
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Zip | 33873-2051
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Country | US
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Telephone | 863-773-4161
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Fax | 863-773-0978
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Authorized Official
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Title or Position | FISCAL ASSISTANT II
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Name | EVELYN DELILAH MISHOE
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Credential |
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Telephone | 863-473-6073
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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 |
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License Number State | FL
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