NPIMap

Organization Active NPI

Florida Department of Health

  • Public Health or Welfare Agency
  • Trenton, FL
National Provider Identifier
1205895752
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
119 NE 1St St
Trenton, FL 32693-3428
Phone
(352) 463-3120
Fax
(352) 463-3124
NPI assigned
Mar 22, 2006
Last updated
Aug 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Sable S Bolling
Title
Administrator
Phone
(352) 498-1360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

119 NE 1St St
Trenton, FL 32693-3428

Mailing address

119 NE 1St St
Trenton, FL 32693-3428
Phone (352) 463-3120

Other identifiers 1

IdentifierTypeStateIssuer
027931500MedicaidFL

Other names 1

  • DBA Gilchrist County Health Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120112000058 FL Part B Supplier - Clinic/Group Practice 3072424282 Receives reassigned benefits from 4 practitioners
Practice locations: Trenton, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0717567Gilchrist County Health Department119 NE 1St Street, Trenton, FL 32693Provider-performed microscopyNov 16, 2026

National Provider Directory

National Provider Directory
Tax ID family
Agape Community 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

119 NE 1st St
Trenton, FL 32693
Phone (352) 463-3120

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1205895752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 NE 1ST ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933428",
            "telephone_number": "352-463-3120",
            "fax_number": "352-463-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NE 1ST ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933428",
            "telephone_number": "352-463-3120",
            "fax_number": "352-463-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "BOLLING",
        "authorized_official_first_name": "SABLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-498-1360"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027931500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Gilchrist County Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Trenton, FL

Sources for this page

Verify at the official NPI Registry.