Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT G. HERRON (DIRECTOR OF OPERATIONS)
(850) 245-4512
Entity
Organization
Contact information
Practice address
4052 BALD CYPRESS WAY, BIN AO5, TALLAHASSEE, FL 32399-7021
(850) 245-4036
Mailing address
4052 BALD CYPRESS WAY, BIN AO5, TALLAHASSEE, FL 32399-7021
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6822991
—
FL
Enumeration date
03/14/2006
Last updated
07/30/2024
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