Provider Demographics
NPI:1376618512
Name:ALACHUA COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ALACHUA COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:BELCUORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-334-7900
Mailing Address - Street 1:224 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32641-7516
Mailing Address - Country:US
Mailing Address - Phone:352-334-7900
Mailing Address - Fax:352-955-2376
Practice Address - Street 1:224 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-7516
Practice Address - Country:US
Practice Address - Phone:352-334-7900
Practice Address - Fax:352-955-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAN581582363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300676000Medicaid
FLS84084Medicare UPIN