Provider Demographics
NPI:1922420629
Name:FLORIDA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:CHILDREN'S MEDICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPUTY SECRETARY FOR HEALTH/CMS
Authorized Official - Prefix:DR
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-245-4245
Mailing Address - Street 1:4052 BALD CYPRESS WAY BIN A06
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32399-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2585 MERCHANTS ROW BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32399-1707
Practice Address - Country:US
Practice Address - Phone:850-245-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare