Provider Demographics
NPI:1528034170
Name:FLORIDA DEPARTMENT OF HEALTH
Entity type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AKILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-253-2936
Mailing Address - Street 1:921 N DAVIS ST.
Mailing Address - Street 2:BLDG A, SUITE 251
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-253-1639
Mailing Address - Fax:904-253-1790
Practice Address - Street 1:515 W 6TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4324
Practice Address - Country:US
Practice Address - Phone:904-253-1639
Practice Address - Fax:904-253-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027926900Medicaid
FL075288600Medicaid
FL6765131Medicaid
FL77016Medicare PIN