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Contact Information

NORTHEAST FLORIDA STATE HOSPITAL
7487 S STATE ROAD 121
MACCLENNY, FL32063-5451
 Phone: 904-259-6211
 Fax: 904-259-7104
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for NORTHEAST FLORIDA STATE HOSPITAL

NPI Number 1932202322
LBN Legal business name NORTHEAST FLORIDA STATE HOSPITAL
Authorized official OLGA ARIAS - (SENIOR PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
FL License # OS 7547
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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