NPIMap

Organization Active NPI

Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
National Provider Identifier
1184659450
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
1217 N Pearl St
Jacksonville, FL 32202-3926
Phone
(904) 791-1690
Fax
(904) 791-1626
NPI assigned
Jul 12, 2006
Last updated
Apr 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John W. Parker
Title
Pensacola Lab Director
Phone
(850) 595-8895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X FL Primary

Addresses

Primary practice location

1217 N Pearl St
Jacksonville, FL 32202-3926

Mailing address

50 W Maxwell St
Pensacola, FL 32501-1759
Phone (850) 595-8895

Other identifiers 1

IdentifierTypeStateIssuer
L8298OtherFLBLUE CROSS/BLUE SHIELD

Other names 1

  • DOH Bureau of Laboratories-Pensacola Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080430000891 FL Part B Supplier - Independent Clinical Laboratory 3072424282 5 other NPIs on this enrollment
Practice locations: Jacksonville, FL; Tampa, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bay Co Health185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1217 N Pearl St
Jacksonville, FL 32202
Phone (904) 791-1690

50 W Maxwell St
Pensacola, FL 32501
Phone (904) 791-1690

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.

FacilityTypeRoleSince
Walton Community Health CenterDefuniak Springs, FL, CCN 101136 Federally qualified health center Operational/Managerial Control (100%) Sep 7, 2010
Bradford Community Health Care IncStarke, FL, CCN 101182 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2013

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1184659450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W MAXWELL ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011759",
            "telephone_number": "850-595-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 N PEARL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023926",
            "telephone_number": "904-791-1690",
            "fax_number": "904-791-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PENSACOLA LAB DIRECTOR",
        "authorized_official_telephone_number": "850-595-8895",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "L8298",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOH Bureau of Laboratories-Pensacola",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.