FLORIDA DEPARTMENT OF HEALTH (NPI# 1780017699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780017699 |
| Entity Type | Organization |
| Organization Name | FLORIDA DEPARTMENT OF HEALTH |
| Other Organization Name | DUVAL COUNTY HEALTH DEPARTMENT |
| Practice Address |
3225 University Blvd S Suite 101 Jacksonville FL 32216-2762 |
| Mailing Address |
900 University Blvd N Mc-75 Jacksonville FL 32211-9230 |
| Practice Telephone | 9042531120 |
| Practice Fax Number | 9042532514 |
| Mailing Telephone | 9042532062 |
| Mailing Fax Number | 9042531942 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |
| Authorized Official Name | DR. KELLI T WELLS (DIRECTOR) |
| Authorized Official Telephone | 9042532062 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | FLORIDA DEPARTMENT OF HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 6905561-09 | 05 | |
| FL | 6905561-04 | 05 |
| Other Name | Type Code |
|---|---|
| Duval 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 |
3225 UNIVERSITY BLVD S SUITE 101 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-2762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861454126 | Kerrie Peacock-preston | Physician Assistant | 3225 University Blvd S, Suite 101, Jacksonville, FL 32216-2762 | 2006-04-03 |
| 1144856030 | Sarah Pratico | Nurse Practitioner | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2020-03-23 |
| 1538599493 | Christopher Shuff | Dietitian, Registered | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2013-11-13 |
| 1457624553 | Erin Elisabeth Meyer | Dietitian, Registered | 3225 University Blvd S, Suite 100, Jacksonville, FL 32216-2762 | 2012-02-21 |
| 1477826055 | Sally Erickson Weerts | Dietitian, Registered | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2012-02-14 |
| 1851679732 | Kimberly M Jimenez | Nurse Practitioner | 3225 University Blvd S, Suite 104, Jacksonville, FL 32216-2762 | 2011-07-27 |
| 1013210525 | Lindsey A Sowders | Dietitian, Registered | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2010-12-06 |
| 1629398359 | Denitza Issaeva Mladenova | Dietitian, Registered | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2010-06-04 |
| 1356570006 | Kathrine Marie Foreman | Dietitian, Registered | 3225 University Blvd S, Jacksonville, FL 32216-2762 | 2009-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518469527 | Special Health Resources for Texas, Incorporated | Clinic/Center | 1011 College Street, Jacksonville, TX 75766-3307 | 2018-03-06 |
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1497010425 | Fl Department of Health | Clinic/Center | 1736 University Blvd S, Jacksonville, FL 32216-8929 | 2012-07-05 |
| 1578892485 | Grandmary's House | Clinic/Center | 4828 Evanston Rd, Jacksonville, FL 32208 | 2009-12-24 |
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| 1760963516 | Arcare | Clinic/Center | 1400 Braden St Ste 1, Jacksonville, AR 72076-3721 | 2018-08-28 |
| 1649628009 | Board of Trustees of Southern Illinois University | Clinic/Center | 345 W State St, Jacksonville, IL 62650-1879 | 2016-05-26 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1245695774 | Agape Community Health Center, Inc | Clinic/Center | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-12-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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.