Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
Suwannee County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA BLACKMON RN, BSN, MPH (ADMINISTRATOR)
(386) 362-2708
Entity
Organization
Contact information
Practice address
915 NOBLES FERRY RD, PO DRAWER 6030, LIVE OAK, FL 32064-2800
(386) 362-2708
(386) 362-6301
Mailing address
PO DRAWER 6030, 915 NOBLES FERRY ROAD, LIVE OAK, FL 32064-2800
(386) 362-2708
(386) 362-6301
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
—
FL
124Q00000X
Dental Hygienist
—
FL
126800000X
Dental Assistant
—
FL
251K00000X
Public Health or Welfare Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051832800
—
FL
05
—
051832809
—
FL
05
—
051832830
—
FL
Enumeration date
06/21/2006
Last updated
10/29/2012
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