Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Parent organization
FLORIDA DEPARTMENT OF HEALTH
Other names
Jackson County Health Department
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Authorized official
MRS. SUSANNAH CULBREATH (BILLING ADMINISTRATOR)
(850) 526-2412
Entity
Organization
Contact information
Practice address
4979 HEALTHY WAY, MARIANNA, FL 32446-7993
(850) 526-2412
(850) 718-0383
Mailing address
4979 HEALTHY WAY, PO BOX 310, MARIANNA, FL 32446-7993
(850) 526-2412
(850) 718-0383
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
ME86600
FL
251K00000X
Public Health or Welfare Agency
Primary
ME86600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027942100
—
FL
01
—
97896
BCBS
FL
Enumeration date
11/09/2006
Last updated
10/14/2024
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