Provider Demographics
NPI:1487813432
Name:DIOCESE OF FLORIDA HOC AJ INC
Entity type:Organization
Organization Name:DIOCESE OF FLORIDA HOC AJ INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ARCHBISHOP
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:DC MD
Authorized Official - Phone:850-673-8338
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:310 SW RANCE AVE
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32341-0128
Mailing Address - Country:US
Mailing Address - Phone:850-673-8338
Mailing Address - Fax:850-253-0069
Practice Address - Street 1:310 SW RANGE AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2324
Practice Address - Country:US
Practice Address - Phone:850-673-8338
Practice Address - Fax:850-253-0069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIOCESE OF FLORIDA HOC AJ INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2180251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable