Organization · Type 2 NPI

Northeast Florida Health Services, Inc.

Federally Qualified Health Center (FQHC) · Pierson, FL

NPI number 1992792311 Active

Practice location

216 N. Frederick Street
Pierson, FL 32180

Call (386) 202-6025 Map

Fax (386) 200-4563

Mailing address

1205 S Woodland Blvd Ste 3
Deland, FL 32720-7464

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1992792311
Entity type: Organization (Type 2)
Issued: Sep 30, 2005
Last updated: Mar 16, 2023
Status: Active
Subpart: Yes of Northeast Florida Health Services, Inc.

Other names

<unavail>
Family Health Source · doing business as

Authorized official

Dina Geoghegan
Credentialing/contracts Admin
(386) 327-4781

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1992792311

Northeast Florida Health Services, Inc.'s National Provider Identifier is 1992792311, issued on Sep 30, 2005. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Pierson, FL. The record was last updated on Mar 16, 2023.