Provider Demographics
NPI:1558302042
Name:FLORIDA HEALTH CARE PLAN, INC
Entity type:Organization
Organization Name:FLORIDA HEALTH CARE PLAN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATANASOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-676-7117
Mailing Address - Street 1:2440 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5110
Mailing Address - Country:US
Mailing Address - Phone:386-615-4021
Mailing Address - Fax:386-676-7193
Practice Address - Street 1:2450 MASON AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5110
Practice Address - Country:US
Practice Address - Phone:386-615-4021
Practice Address - Fax:386-676-7193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21156OtherBCBS
FL21156OtherBCBS
FL250255100Medicaid
FLDP5943OtherRAIL ROAD