1326205600 NPI number — WELLCARE OF FLORIDA, INC.

Table of content: (NPI 1326205600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326205600 NPI number — WELLCARE OF FLORIDA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLCARE OF FLORIDA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326205600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8735 HENDERSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33634-1143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-290-6200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3031 N. ROCKY POINT DRIVE W.
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-290-6200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HABER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
VP & SECRETARY
Authorized Official Telephone Number:
813-206-1490

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 015016909 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016913 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015056801 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016906 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015077102 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016908 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016912 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016914 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015077100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015077103 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016901 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016902 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016907 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015077101 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016903 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016904 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016905 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016910 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015016911 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015056800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com