Provider Demographics
NPI:1942250303
Name:VOLUNTEERS OF AMERICA OF FLORIDA, INC
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA OF FLORIDA, INC
Other - Org Name:VOLUNTEERS OF AMERICA OF FLORIDA, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:BURGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-498-4807
Mailing Address - Street 1:405 CENTRAL AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3866
Mailing Address - Country:US
Mailing Address - Phone:727-369-8500
Mailing Address - Fax:727-823-8286
Practice Address - Street 1:716 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-4800
Practice Address - Country:US
Practice Address - Phone:904-239-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070744900Medicaid
FL029943000Medicaid
FL360005000Medicaid
FL360041600Medicaid
FL029943001Medicaid