Provider Demographics
NPI:1215047675
Name:BOARD OF COUNTY COMMISSIONERS LEON COUNTY
Entity type:Organization
Organization Name:BOARD OF COUNTY COMMISSIONERS LEON COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-606-5300
Mailing Address - Street 1:PO BOX 863353
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-0001
Mailing Address - Country:US
Mailing Address - Phone:305-459-0664
Mailing Address - Fax:305-421-0928
Practice Address - Street 1:911 EASTERWOOD DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311
Practice Address - Country:US
Practice Address - Phone:850-606-2100
Practice Address - Fax:850-606-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3226341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL400101000Medicaid
FLU2159Medicare ID - Type Unspecified
FL400101000Medicaid