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NPI Code Detail

MEDICARE: FLORIDA DEPARTMENT OF HEALTH

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
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
177048OTHERFLBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780653766
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA DEPARTMENT OF HEALTH
Provider Business Mailing Address
First Line : PO BOX 70
Second Line :
City : LABELLE
State : FL
Zip : 33975-0070
Country : US
Telephone Number : 863-674-4056
Fax Number : 863-674-4076
Provider Business Practice Location Address
First Line : 1140 PRATT BLVD
Second Line :
City : LABELLE
State : FL
Zip : 33935-4405
Country : US
Telephone Number : 863-674-4056
Fax Number : 863-674-4076
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MS. SHIRLEY LYNN THOMAS
Credential :
Telephone Number : 863-674-4056
Provider Enumeration Date : 03/14/2006
Last Update Date : 08/22/2020

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Directions to “FLORIDA DEPARTMENT OF HEALTH ” Practice Location

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