Active NPI
Florida Department of Health
- Public Health or Welfare Agency
- Tampa, FL
National Provider Identifier
1124090832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- FLORIDA DEPARTMENT OF HEALTH
- Practice address
- 1105 E Kennedy Blvd
Tampa, FL 33602-3511 - Phone
- (813) 559-4344
- Fax
- (813) 276-2999
- NPI assigned
- Feb 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Suzette McNeil
- Title
- Government Operations Consultant II
- Phone
- (813) 559-4344
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Primary |
Addresses
Primary practice location
1105 E Kennedy Blvd
Tampa, FL 33602-3511
Mailing address
1105 E Kennedy Blvd
Tampa, FL 33602-3591
Phone (813) 559-4344
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00077128 | Other | FL | MEDICARE IDENTIFICATION NUMBER |
| 055726900 | Medicaid | FL | |
| 99661 | Other | FL | BLUE CROSS BLUE SHIELD |
Other names 1
- Hillsborough County Health Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050930000520 | FL | Part B Supplier - Clinic/Group Practice | 3072424282 |
Receives reassigned benefits from 14 practitioners 1 other NPI on this enrollment Practice locations: Tampa, FL |
| O20181228000197 | FL | MDPP Supplier - in-Person MDPP Supplier | 3072424282 | Practice locations: Tampa, FL |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Public Health or Welfare Agency
- Tampa, FL
- NPI 1619047941
O20050930000520
National Provider Directory
National Provider DirectoryLocations
1105 E Kennedy Blvd
Tampa, FL 33602
Phone (813) 307-8015
4704B W Montgomery Ave
Tampa, FL 33616
Phone (813) 307-8015
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Walton Community Health Center | Federally qualified health center | Operational/Managerial Control (100%) | Sep 7, 2010 |
| Bradford Community Health Care Inc | Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
Practitioners & affiliated clinicians
Practitioners 32
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778112000000",
"number": "1124090832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 E KENNEDY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023591",
"telephone_number": "813-559-4344",
"fax_number": "813-276-2999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 E KENNEDY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023511",
"telephone_number": "813-559-4344",
"fax_number": "813-276-2999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLORIDA DEPARTMENT OF HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-06",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A",
"authorized_official_last_name": "MCNEIL",
"authorized_official_first_name": "SUZETTE",
"authorized_official_title_or_position": "GOVERNMENT OPERATIONS CONSULTANT II",
"authorized_official_telephone_number": "813-559-4344"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE IDENTIFICATION NUMBER",
"identifier": "00077128",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "055726900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "99661",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hillsborough County Health Department",
"code": "5",
"type": "Other Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.