Provider First Line Business Practice Location Address:
FLORIDA DEPT HEALTH
Provider Second Line Business Practice Location Address:
4052 BALD CYPRESS WAY, BIN A23
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32399-1748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-245-4787
Provider Business Practice Location Address Fax Number:
850-922-0462
Provider Enumeration Date:
05/16/2007