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NORTHEAST FLORIDA HEALTH SERVICES INC. NPI 1790452688


NPI Information

NPI: 1790452688
Provider Name: NORTHEAST FLORIDA HEALTH SERVICES, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D1026293

Address:
2160 HOWLAND BLVD STE 110
DELTONA, FL
ZIP 32738
Phone: (386) 532-0515
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NORTHEAST FLORIDA HEALTH SERVICES, INC. is a family medicine in Deltona, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NORTHEAST FLORIDA HEALTH SERVICES, INC. NPI is 1790452688. The provider is registered as an organization entity type.

The provider's business location address is:

2160 HOWLAND BLVD STE 110
DELTONA, FL
ZIP 32738-468
Phone: (386) 532-0515
Fax: (386) 532-0516

The provider's authorized official is Laurie Asbury .
The authorized official title is Ceo and has the following contact phone number (386) 749-9449.

The CLIA number assigned to this NPI record is 10D1026293 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/27/2021 and was last updated on 8/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1687955105MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.