Provider Demographics
NPI:1932177409
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:ADMINISTRATOR/HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:850-564-2233
Mailing Address - Street 1:PO BOX 929
Mailing Address - Street 2:5527 STEWART ST
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32572-0929
Mailing Address - Country:US
Mailing Address - Phone:850-983-5200
Mailing Address - Fax:850-983-4816
Practice Address - Street 1:5527 STEWART ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32572
Practice Address - Country:US
Practice Address - Phone:850-983-5200
Practice Address - Fax:850-983-4816
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA DEPARTMENT OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-10
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02796760Medicaid
72577Medicare ID - Type Unspecified