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Organization

FL DEPARTMENT OF HEALTH

Active
Parent organization
FLORIDA DEPARTMENT OF HEALTH
Other names
Duval County Health Department
Organization subpart
Yes

Provider details

NPI number
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Authorized official
DR. KELLI T WELLS M.D. (DIRECTOR)
(904) 253-2062
Entity
Organization

Contact information

Practice address
1736 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-8929
(904) 253-1100
(904) 727-6548
Mailing address
900 UNIVERSITY BLVD N, MC-75, JACKSONVILLE, FL 32211-9230
(904) 253-2062
(904) 253-1942

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6905561-02
FL
05
6905561-03
FL
Enumeration date
07/05/2012
Last updated
08/14/2013
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