Provider Demographics
NPI:1659344620
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:HIGHLANDS COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DEPARTMENT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-386-7238
Mailing Address - Street 1:7205 S GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-5847
Mailing Address - Country:US
Mailing Address - Phone:863-386-6040
Mailing Address - Fax:863-382-7279
Practice Address - Street 1:7205 S GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-5847
Practice Address - Country:US
Practice Address - Phone:863-386-6040
Practice Address - Fax:863-382-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027938200Medicaid
FL77878Medicare PIN