Florida Department of Health
Organization Active NPI Public Health or Welfare Agency · Jasper, FL
NPI 1851350409 · NPPES record last updated May 7, 2025
Key facts
- NPI
- 1851350409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- FLORIDA DEPARTMENT OF HEALTH
- Practice address
- 209 Central Ave SE
Jasper, FL 32052-6153 - Phone
- (386) 792-1414
- Fax
- (386) 792-2352
- NPI assigned
- Mar 22, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- FLORIDA DEPARTMENT OF HEALTH
Authorized official
- Name
- Mrs. Diana Duque
- Title
- Interim Administrator
- Phone
- (352) 727-0542
Corporate family (same tax ID) 24
Practitioners 6
-
Alicia Cosma Gilbert, FNP
-
Andrea Sciberras, D.O.
-
Mona Payne, R.N.
-
Nancy Wiegand, R.N.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0894063 | Florida Department of Health Hamilton Co Health | Provider-performed microscopy | Nov 21, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Walton Community Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Sep 7, 2010 |
| Bradford Community Health Care Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041208001052 | FL | Part B Supplier - Clinic/Group Practice | 3072424282 |
Receives reassigned benefits from 4 practitioners Practice locations: Jasper, FL |
National Provider Directory
- Tax ID family
- Dept of Health Central Pharmacy
- Part of
- Dept of Health Central Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | FL | Yes |
Addresses
Primary practice location
209 Central Ave SE
Jasper, FL 32052-6153
Mailing address
PO Box 267
Jasper, FL 32052-0267
Phone (386) 792-1414
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027934000 | Medicaid | FL |
Other names
- HAMILTON CO HLTH DEPT
- Hamilton County Health Department
Other providers in Jasper, FL
- Hannah G. Deas
- Dedicated Nursing Care, LLC
- Enrique Technologies Inc
- Family to Family Helping Hands, LLC
- Fdlrs/Gateway
- Martha Fultz
- Sharon B Gay
- Gentle Love and Care Assisted Living Facility
- Gentle Love and Care LLC
- Gentle Love and Care LLC
All providers in Jasper, FL · Public Health or Welfare Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.