| Northeast Florida Health Services, Inc. | |
|
216 Frederick St Pierson FL 32180-3024 | |
| (386) 749-9449 | |
| (386) 749-9447 |
| Full Name | Northeast Florida Health Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 216 Frederick St, Pierson, Florida |
| Authorized Official Name and Position | Rebecca Collier (CREDENTIALING/CONTRACTS ADMIN) |
| Authorized Official Contact | 3862026025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Florida Health Services, Inc. 1205 S Woodland Blvd Ste 3 Deland FL 32720-7464 Ph: (386) 202-6025 | Northeast Florida Health Services, Inc. 216 Frederick St Pierson FL 32180-3024 Ph: (386) 749-9449 |
| NPI Number | 1609543503 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 08/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609543503 | NPI | - | NPPES |
| 687955101 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
Family Health Source Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 216 N. Frederick Street, Pierson, FL 32180 Phone: 386-202-6025 Fax: 386-200-4563 |