Provider Demographics
NPI:1952709172
Name:JEFFERSON COUNTY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:JEFFERSON COUNTY DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE AUTOMATION ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:850-342-0170
Mailing Address - Street 1:1255 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-1128
Mailing Address - Country:US
Mailing Address - Phone:850-342-0170
Mailing Address - Fax:850-342-0257
Practice Address - Street 1:1255 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-1128
Practice Address - Country:US
Practice Address - Phone:850-342-0170
Practice Address - Fax:850-342-0257
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA DEPARTMENT OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN798931251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare