NPIMap

Organization Active NPI

Florida Health Care Plan, Inc

Doing business as Florida Health Care Plans Pharmacy-St. Augustine

  • Managed Care Organization Pharmacy
  • St Augustine, FL
National Provider Identifier
1467964494
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
PH31002 Issued in FL
Legal business name
FLORIDA HEALTH CARE PLAN, INC
Doing business as
Florida Health Care Plans Pharmacy-St. Augustine
Practice address
200 Southpark Blvd Ste 206
St Augustine, FL 32086-3129
Phone
(904) 295-3677
Fax
(904) 295-3679
NPI assigned
Oct 31, 2017
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Dr. Christopher J Smith
Title
Cmo
Phone
(386) 615-5008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Managed Care Organization Pharmacy 3336M0003X PH31002 FL Primary

Addresses

Primary practice location

200 Southpark Blvd Ste 206
St Augustine, FL 32086-3129

Mailing address

2450 Mason Ave
Daytona Beach, FL 32114-5110
Phone (386) 615-5008

Other identifiers 1

IdentifierTypeStateIssuer
PH31002OtherFLSTATE LICENSE

Other names 1

  • Florida Health Care Plans Pharmacy-St. Augustine Doing business as

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
10D2257734Florida Health Care Plan, Inc200 Southpark Blvd - Ste 208, St Augustine, FL 32086Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Florida HLTH Care Plan20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

200 Southpark Blvd
Ste 206
St Augustine, FL 32086
Phone (904) 295-3677

Practitioners & affiliated clinicians

Practitioners 1

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": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1467964494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145110",
            "telephone_number": "386-615-5008",
            "fax_number": "386-676-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTHPARK BLVD STE 206",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863129",
            "telephone_number": "904-295-3677",
            "fax_number": "904-295-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEALTH CARE PLAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "386-615-5008",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "FL",
            "license": "PH31002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PH31002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Health Care Plans Pharmacy-St. Augustine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.