Organization
CMS JACKSONVILLE
Active
Other names
Florida Department of Health Childrens Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY KEATHLEY (PROGRAM ADMINISTRATOR)
(352) 334-1394
Entity
Organization
Contact information
Practice address
910 NORTH JEFFERSON STREET, JACKSONVILLE, FL 32209-6810
(904) 360-7070
(904) 798-4568
Mailing address
910 NORTH JEFFERSON STREET, JACKSONVILLE, FL 32209-6810
(904) 360-7070
(904) 798-4568
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
FL
Other
Enumeration date
02/28/2006
Last updated
08/14/2007
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