Provider Demographics
NPI:1346446895
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:GADSDEN COUNTY HEALTH DEPARMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-875-7200
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32353-1000
Mailing Address - Country:US
Mailing Address - Phone:850-875-7200
Mailing Address - Fax:875-087-5721
Practice Address - Street 1:278 DR. LESALLE LEFFALL DRIVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351
Practice Address - Country:US
Practice Address - Phone:850-875-7200
Practice Address - Fax:850-875-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0279307-00Medicaid
FL0279307-02Medicaid
FL0279307-01Medicaid
FL0279307-12Medicaid
FL0279307-03Medicaid
FL0279307-30Medicaid
FL0279307-04Medicaid