Florida Department of Health

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800000352 Issued in FL

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

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

Authorized official

Name

Aurora C. Grospe

Title

Accountant I - Billing Manager

Phone

(904) 791-1690

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DOH Bureau of Laboratories - Miami Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Bureau of Public Health Laboratories

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1518983642

  O20080430000891

  Same enrollment
• Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1043245038

  O20080430000891

  Same enrollment
• Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1174558431

  O20080430000891

  Same enrollment
• Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1184659450

  O20080430000891

  Same enrollment
• Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1821023011

  O20080430000891

  Same enrollment

Locations

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": "1851326284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 NW 14TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251614",
            "telephone_number": "904-791-1690",
            "fax_number": "904-791-1626"
        },
        {
            "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": "GROSPE",
        "authorized_official_first_name": "AURORA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ACCOUNTANT I - BILLING MANAGER",
        "authorized_official_telephone_number": "904-791-1690"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800000352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "L8304",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030736000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOH Bureau of Laboratories - Miami",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Florida Department of Health
• Florida Department of Health (Duval County Health Department)
• Florida Department of Health (Duval Co Health Dept)
• Florida Department of Health (Duval County Health Department)
• Florida Department of Health
• Florida Em-I Medical Services PA
• Florida Em-I Medical Services PA
• Florida Em-I Medical Services PA
• Florida Em-I Medical Services, PA
• Florida Em-I Medical Services, PA

• Clinical Medical Laboratory in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.