NPIMap

Organization Active NPI

Florida Department of Health

Doing business as lake county health Department

  • Public Health or Welfare Agency
  • Eustis, FL
National Provider Identifier
1679548861
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Doing business as
lake county health Department
Practice address
16140 US Hwy 441
Eustis, FL 32726-1305
Phone
(352) 589-6424
Fax
(352) 589-6492
NPI assigned
Feb 21, 2006
Last updated
Mar 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Mr. Aaron Kissler
Title
Administrator
Phone
(352) 589-6424

Specialties & licenses 1

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

Addresses

Primary practice location

16140 US Hwy 441
Eustis, FL 32726-1305

Mailing address

P.O. Box 1305
Tavares, FL 32778-1305
Phone (352) 589-6424

Other names 1

  • lake county health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100518000211 FL Part B Supplier - Clinic/Group Practice 3072424282 Receives reassigned benefits from 8 practitioners
Practice locations: Clermont, FL; Leesburg, FL; Umatilla, FL

National Provider Directory

National Provider Directory

Locations

875 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 483-7977

16140 US Highway 441
Eustis, FL 32726
Phone (352) 360-6548

2113 Griffin Rd
Leesburg, FL 34748
Phone (352) 483-7977

249 E Collins St
Umatilla, FL 32784
Phone (352) 483-7977

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 11

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": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1679548861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1305",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327781305",
            "telephone_number": "352-589-6424",
            "fax_number": "352-589-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16140 US HWY 441",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327261305",
            "telephone_number": "352-589-6424",
            "fax_number": "352-589-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "KISSLER",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-589-6424",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "lake county health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eustis, FL

Sources for this page

Verify at the official NPI Registry.