Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
DOH Bureau of Labs-Central Lab Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AURORA GROSPE (ACCOUNTANT I - BILLING MANAGER)
(904) 791-1690
Entity
Organization
Contact information
Practice address
1217 PEARL ST, JACKSONVILLE, FL 32202-3926
(904) 791-1690
(904) 791-1626
Mailing address
1217 N PEARL ST, P.O. BOX 210, JACKSONVILLE, FL 32202-3926
(904) 791-1690
(904) 791-1626
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800000296
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030280500
—
FL
01
—
AJ103
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/12/2006
Last updated
03/25/2015
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