Provider Demographics
NPI:1518692185
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:386-437-7350
Mailing Address - Street 1:301 DR. CARTER BLVD
Mailing Address - Street 2:PO BOX 847
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-6212
Mailing Address - Country:US
Mailing Address - Phone:386-427-7350
Mailing Address - Fax:386-437-7353
Practice Address - Street 1:301 DR CARTER BLVD
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-6212
Practice Address - Country:US
Practice Address - Phone:386-427-7350
Practice Address - Fax:386-437-7353
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA DEPARTMENT OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX1583OtherBLUE CROSS/BLUE SHIELD
FL027928500Medicaid
FLP00235603OtherRAILROAD MEDICARE