Provider Demographics
NPI:1134189103
Name:FLORIDA DEPARTMENT OF HEALTH
Entity type:Organization
Organization Name:FLORIDA DEPARTMENT OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNTY HEALTH DEPARTMENT DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-671-4021
Mailing Address - Street 1:800 CLEMATIS ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5107
Mailing Address - Country:US
Mailing Address - Phone:561-671-4117
Mailing Address - Fax:561-837-5202
Practice Address - Street 1:1150 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2361
Practice Address - Country:US
Practice Address - Phone:561-514-5300
Practice Address - Fax:561-514-5538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052033100Medicaid
FLDU1464OtherRAILROAD MEDICARE/PALMETTO GBA
FL052033170Medicaid
FL052033110Medicaid
FL052033160Medicaid
FL052033115Medicaid
FL052033150Medicaid
FL052033180Medicaid
FL052033120Medicaid
FL052033102Medicaid
FLDU1464OtherRAILROAD MEDICARE/PALMETTO GBA
FL052033120Medicaid
K2648Medicare PIN
FL052033150Medicaid
FL052033170Medicaid