MEDICARE: COUNTY OF DESOTO BOARD COUNTY COMMISSIONERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	002495	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590005624	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	089257100	OTHER	FL	BLACK LUNG
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003896077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF DESOTO BOARD COUNTY COMMISSIONERS

Provider Business Mailing Address
First Line	:	122 N HILLSBOROUGH AVE
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-4419
Country	:	US
Telephone Number	:	863-993-4842
Fax Number	:	863-993-4844

Provider Business Practice Location Address
First Line	:	1985 SE CARLSTROM FIELD RD
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-7748
Country	:	US
Telephone Number	:	863-993-4842
Fax Number	:	863-993-4844

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	CHAD A JORGENSEN
Credential	:
Telephone Number	:	863-993-4842

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	05/06/2026

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Directions to “COUNTY OF DESOTO BOARD COUNTY COMMISSIONERS ” Practice Location

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