# CMS JACKSONVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Florida Department of Health Childrens Medical Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093781064
- **Authorized official:** MS. CATHY KEATHLEY (PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (352) 334-1394

## Contact information

- **Practice address:** 910 NORTH JEFFERSON STREET, JACKSONVILLE, FL 32209-6810
- **Practice address phone:** (904) 360-7070
- **Practice address fax:** (904) 798-4568
- **Mailing address:** 910 NORTH JEFFERSON STREET, JACKSONVILLE, FL 32209-6810
- **Mailing address phone:** (904) 360-7070
- **Mailing address fax:** (904) 798-4568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | FL | Yes |

## Other

- **Enumeration date:** 02/28/2006
- **Last updated:** 08/14/2007