MEDICARE: FLORIDA DEPARTMENT OF HEALTH

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	251K00000X	Public Health or Welfare Agency		FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00235603	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	X1583	OTHER	FL	BLUE CROSS/BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285600213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA DEPARTMENT OF HEALTH

Provider Business Mailing Address
First Line	:	301 DR CARTER BLVD
Second Line	:	PO BOX 847
City	:	BUNNELL
State	:	FL
Zip	:	32110-6212
Country	:	US
Telephone Number	:	386-437-7350
Fax Number	:	386-437-8207

Provider Business Practice Location Address
First Line	:	301 DR CARTER BLVD
Second Line	:
City	:	BUNNELL
State	:	FL
Zip	:	32110-6212
Country	:	US
Telephone Number	:	386-437-7350
Fax Number	:	386-437-8207

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. PATRICK JOHNSON
Credential	:	R.N
Telephone Number	:	386-437-7350

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	02/12/2015

Similar Medicare Providers

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Practice Location Address:

301 DR CARTER BLVD
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32110-6212

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Practice Fax:

1760458798 — MRS. FRANCES ELIZABETH BEY D.M.D.
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1164498101 — MRS. DEBORAH A FRAZER ARNP
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1871569806 — MRS. DEBORAH ANNE PANCHELLA ARNP
Practice Location Address:

301 S LEMON ST
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1912094319 — STEPHEN R. BICKEL M.D.
Practice Location Address:

301 DR CARTER BLVD
BUNNELL, FL
32110-6212

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1376617654 — STATE OF FLORIDA DEPARTMENT OF HEALTH
Practice Location Address:

301 S LEMON ST
BUNNELL, FL
32110-6212

Practice Phone: 386-437-7350
Practice Fax: 386-437-7353

Directions to “FLORIDA DEPARTMENT OF HEALTH ” Practice Location

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