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General NPI Number Information
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NPI Number | 1851326284
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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 | 07/12/2006
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1217 N PEARL ST
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City | JACKSONVILLE
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State | FL
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Zip | 32202-3926
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Country | US
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Telephone | 904-791-1690
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Fax | 904-791-1626
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Provider Business Mailing Address
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Address Line | 1325 NW 14TH AVE
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City | MIAMI
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State | FL
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Zip | 33125-1614
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Country | US
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Telephone | 904-791-1690
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Fax | 904-791-1626
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Authorized Official
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Title or Position | ACCOUNTANT I - BILLING MANAGER
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Name | AURORA C. GROSPE
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Credential |
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Telephone | 904-791-1690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800000352
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License Number State | FL
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