Provider Demographics
NPI:1245200641
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:MADISON COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR JEFFERSON MADISON CHD
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-973-5000
Mailing Address - Street 1:218 SW THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-1266
Mailing Address - Country:US
Mailing Address - Phone:850-973-5000
Mailing Address - Fax:850-973-5007
Practice Address - Street 1:218 SW THIRD AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-1266
Practice Address - Country:US
Practice Address - Phone:850-973-5000
Practice Address - Fax:850-973-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029040800Medicaid
FL24134Medicare ID - Type Unspecified