FLORIDA DEPARTMENT OF HEALTH (NPI# 1629259940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629259940 |
| Entity Type | Organization |
| Organization Name | FLORIDA DEPARTMENT OF HEALTH |
| Other Organization Name | FLORIDA DEPARTMENT OF HEALTH LIBERTY COUNTY HEALTH DEPARTMENT |
| Practice Address |
12832 Nw Central Ave Bristol FL 32321 |
| Mailing Address |
Po Box 489 Bristol FL 32321-0489 |
| Practice Telephone | 8506432415 |
| Practice Fax Number | 8506435689 |
| Mailing Telephone | 8506432415 |
| Mailing Fax Number | 8506435689 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2007-11-28 |
| Authorized Official Name | EUGENE G. CHARBONNEAU (DIRECTOR) |
| Authorized Official Telephone | 8506432415 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Florida Department of Health Liberty County Health Department | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912271701 | Florida Department of Health | Public Health or Welfare | 17316 Ne Sr 65, Hosford, FL 32334-9998 | 2012-02-27 |
| 1467726257 | Florida Department of Health | Public Health or Welfare | 1839 East Main Street, Pahokee, FL 33476-1113 | 2012-02-27 |
| 1679843569 | Florida Department of Health | Public Health or Welfare | 2585 Merchants Row Blvd, Bin A05, Tallahassee, FL 32311-3645 | 2012-01-09 |
| 1235411158 | Florida Department of Health | Public Health or Welfare | 6405 W Indiantown Rd, Jupiter, FL 33458-3952 | 2011-09-16 |
| 1285806224 | Florida Department of Health | Public Health or Welfare | 1701 Sw 16th Ave Bldg B, Gainesville, FL 32608-1153 | 2008-03-31 |
| 1346446895 | Florida Department of Health | Public Health or Welfare | 278 Dr. Lesalle Leffall Drive, Quincy, FL 32351 | 2007-06-22 |
| 1992846539 | Florida Department of Health | Pharmacy | 83 Pondella Rd, North Fort Myers, FL 33903-4411 | 2007-02-08 |
| 1891874707 | Florida Department of Health | Public Health or Welfare | 120 Suwannee Ave, Branford, FL 32008 | 2006-11-02 |
| 1386751907 | Florida Department of Health | Clinic/Center | 2575 N Courtney Pkwy, Merritt Island, FL 32953 | 2006-08-23 |
| 1306868807 | Florida Department of Health | Pharmacy | 2421 Sw 6th Ave, Ft Lauderdale, FL 33315-2613 | 2006-07-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FLORIDA DEPARTMENT OF HEALTH ST JOHNS COUNTY | 200 San Sebastian View Ste 1100, Saint Augustine, FL 32084-8695 |
| Street Address |
12832 NW CENTRAL AVE |
| City | BRISTOL |
| State | FL |
| Zip Code | 32321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679567796 | John David Smith | Dentist | 12832 Nw Central Ave, Bristol, FL 32424 | 2005-09-02 |
| 1477966521 | Gidgetta Thomas | Licensed Practical Nurse | 12832 Nw Central Ave, Bristol, FL 32321-6918 | 2014-06-06 |
| 1609289792 | Joanna Peacock | Registered Nurse | 12832 Nw Central Ave, Bristol, FL 32321-6918 | 2014-06-05 |
| 1174940308 | Melissa Kincaid | Dental Hygienist | 12832 Nw Central Ave, Liberty County Health Department, Bristol, FL 32321-6918 | 2014-03-26 |
| 1568736353 | Florida Department of Health | Public Health or Welfare | 12832 Nw Central Ave, Bristol, FL 32321-6918 | 2012-02-27 |
| 1104107226 | Sandra Jean Ford | Nurse Practitioner | 12832 Nw Central Ave, Bristol, FL 32321-6918 | 2011-09-01 |
| 1710910849 | Jocelyn I Stowell | Advanced Practice Midwife | 12832 Nw Central Ave, Bristol, FL 32321-0489 | 2006-07-09 |
| 1578533808 | Cynthia Marie Kimbrel | Licensed Practical Nurse | 12832 Nw Central Ave, Bristol, FL 32321 | 2006-01-26 |
| 1568432524 | Angela Rose Bracewell | Registered Nurse | 12832 Nw Central Ave, Bristol, FL 32321 | 2006-01-24 |
| 1184694283 | Karla Grace Johnson | Licensed Practical Nurse | 12832 Nw Central Ave, Bristol, FL 32321 | 2006-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649739194 | Amberly Portero | Counselor | 10611 Florida Highway 20, Bristol, FL 32321 | 2019-03-14 |
| 1194281121 | Ash Bailey Smith | Social Worker | 10659 Nw Sr 20, Bristol, FL 32321 | 2019-02-14 |
| 1508295692 | Maggie Chavez | Counselor | 12422 Ne Revell Road, Bristol, FL 32321 | 2013-11-08 |
| 1437586609 | Queen Brown Haven Assisted Living Facility | Assisted Living Facility | 6906 Nw Torreya Park Road, Bristol, FL 32321 | 2013-10-03 |
| 1538400072 | Ruby Lee Varnum | Assisted Living Facility | 12167 Nw Freeman Rd, Bristol, FL 32321 | 2013-03-08 |
| 1417233321 | April Dawn Landrum | Case Management | 13888 Nw Cr 12, Apalachee Center, Inc., Bristol, FL 32321 | 2011-10-25 |
| 1417191107 | Elizabeth Stephanie Hofrichter | Social Worker | 11033 Nw Sr 20, Bristol, FL 32321 | 2009-04-24 |
| 1275734881 | Efren L Baltazar | Obstetrics & Gynecology | 2571 Executive Center Circle East, Howard Building Division of Disability Determination, Tallahassee, FL 32321 | 2007-05-30 |
| 1336260322 | Laban Bontrager | Dentist | 12761 Ne Pea Ridge Rd, Bristol, FL 32321 | 2007-04-03 |
| 1225192404 | Liberty County School Board | Local Education Agency (LEA) | 12926 Nw Cr 12, Bristol, FL 32321 | 2006-12-21 |
| Find all providers in zip 32321 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750610325 | Seminole Tribe of Florida Health Department | Clinic/Center | 17201 Civic St. Ne, Okeechobee, FL 34974-2729 | 2009-12-10 |
| 1144551748 | Seminole Tribe of Florida Health Dept. | Clinic/Center | 3006 Josie Billie Ave, Hollywood, FL 33024 | 2010-01-21 |
Please comment or provide details below to improve the information on FLORIDA DEPARTMENT OF HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.