Provider Demographics
NPI:1558334367
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:COLLIER COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CHD ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-252-8206
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0429
Mailing Address - Country:US
Mailing Address - Phone:239-252-8200
Mailing Address - Fax:
Practice Address - Street 1:3339 E TAMIAMI TRL STE 145
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-5361
Practice Address - Country:US
Practice Address - Phone:239-252-8200
Practice Address - Fax:239-252-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027921811Medicaid
FL027921815Medicaid
FL027921801Medicaid
FL027921819Medicaid
FL027921800Medicaid
FL99635OtherBCBSFL
FL027921806Medicaid
FL027921807Medicaid
FL027921808Medicaid
FL027921807Medicaid