Provider Demographics
NPI:1942467212
Name:WELLCARE OF FLORIDA, INC.
Entity Type:Organization
Organization Name:WELLCARE OF FLORIDA, INC.
Other - Org Name:HEALTHEASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-206-1490
Mailing Address - Street 1:8735 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1143
Mailing Address - Country:US
Mailing Address - Phone:813-290-6200
Mailing Address - Fax:
Practice Address - Street 1:3031 N. ROCKY POINT DRIVE W.
Practice Address - Street 2:SUITE 600
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-290-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLCARE HEALTH PLANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015019300Medicaid
FL015019304Medicaid
FL015019308Medicaid
FL015019315Medicaid
FL015019320Medicaid
FL015019327Medicaid
FL015019339Medicaid
FL015057601Medicaid
FL015019318Medicaid
FL015019329Medicaid
FL015019340Medicaid
FL015019317Medicaid
FL015019322Medicaid
FL015019333Medicaid
FL015019336Medicaid
FL015019338Medicaid
FL015019323Medicaid
FL015019324Medicaid
FL015019332Medicaid
FL015019314Medicaid
FL015019335Medicaid
FL015019319Medicaid
FL015019331Medicaid
FL015019342Medicaid
FL015019301Medicaid
FL015019302Medicaid
FL015019309Medicaid
FL015019303Medicaid
FL015019328Medicaid
FL015057600Medicaid