Organization
FLORIDA DEPARTMENT OF HEALTH, CHILDREN'S MEDICAL SERVICES HEALTH PLAN
Active
Other names
CMS Health Plan Region 4
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA GARY (DIRECTOR)
(850) 245-4738
Entity
Organization
Contact information
Practice address
2585 MERCHANTS ROW BLVD, TALLAHASSEE, FL 32399-6607
(850) 245-4200
(850) 617-6466
Mailing address
4052 BALD CYPRESS WAY BIN #A06, TALLAHASSEE, FL 32399-1707
(850) 245-4200
(850) 617-6466
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100992704
—
FL
Enumeration date
02/02/2022
Last updated
02/02/2022
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