Organization
CMS ROCKLEDGE
Active
Other names
Florida Department of Health Childrens Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHLEEN MARK (REGIONAL PROGRAM ADMINISTRATOR)
(407) 858-5579
Entity
Organization
Contact information
Practice address
2565 JUDGE FRAN JAMIESON WAY, VIERA, FL 32940-5998
(321) 639-5888
(321) 690-3887
Mailing address
2565 JUDGE FRAN JAMIESON WAY, VIERA, FL 32940-5998
(321) 639-5888
(321) 690-3887
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060189600
—
FL
Enumeration date
10/18/2006
Last updated
11/14/2013
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