Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
Monroe County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EADIE JD (ADMINSTRATOR)
(305) 809-5610
Entity
Organization
Contact information
Practice address
1100 SIMONTON ST, KEY WEST, FL 33040-3110
(305) 293-7500
(305) 292-6872
Mailing address
1100 SIMONTON ST, KEY WEST, FL 33040-3110
(305) 293-7500
(305) 292-6872
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279544 00
—
FL
01
—
AY168
THIRD PARTY
FL
Enumeration date
03/17/2006
Last updated
02/28/2023
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