Provider Demographics
NPI:1922130277
Name:FLORIDA HEALTH CARE PLAN, INC.
Entity Type:Organization
Organization Name:FLORIDA HEALTH CARE PLAN, INC.
Other - Org Name:FLORIDA HEALTH CARE PLANS PHARMACY-HOLLY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-676-7100
Mailing Address - Street 1:2450 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5110
Mailing Address - Country:US
Mailing Address - Phone:386-615-5008
Mailing Address - Fax:
Practice Address - Street 1:1510 RIDGEWOOD AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:FL
Practice Address - Zip Code:32117-2259
Practice Address - Country:US
Practice Address - Phone:386-676-7173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No333600000XSuppliersPharmacy