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NORTHEAST FLORIDA HEALTH SERVICES, INC.
NPI 1164196861
Clinic/Center - Dental in Deltona, FL

Active since August 05, 2021CLIA 10D1026293 · Waiver
1200 DELTONA BLVD STE 40A, DELTONA, FL 32725(386) 202-6025(386) 202-1755 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Northeast Florida Health Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST FLORIDA HEALTH SERVICES, INC. (NPI 1164196861), doing business as Family Health Source, is a healthcare organization registered as a dental in Deltona, Florida and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through June 1, 2028 and lists Laurie Asbury, Ceo, as its authorized official.

NPPES Registry Identity

NPI1164196861
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameNORTHEAST FLORIDA HEALTH SERVICES, INC.
Location Address1200 DELTONA BLVD STE 40ADeltona, FL 32725-6386
Mailing Address1205 S Woodland Blvd Ste 3Deland, FL 32720-7464 · (386) 202-6025 · Fax (386) 202-1755
Phone(386) 202-6025
Fax(386) 202-1755
Organization SubpartYes
Authorized OfficialLaurie AsburyCeo · (386) 749-9449
Enumeration DateAugust 5, 2021
NPPES CertifiedAugust 5, 2021
✔ NPI 1164196861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1200 DELTONA BLVD STE 40A, Deltona, FL 32725
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Other Names 1

Doing Business AsFamily Health Source

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1026293

Northeast Florida Health Services Dba Family Health Source · Deland, FL
Active · expires Jun 1, 2028
CLIA Number10D1026293
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 2, 2026
Certificate Expiration DateJune 1, 2028
Laboratory DirectorMichael J. Ham-Ying
Laboratory Phone(386) 202-6025
Laboratory LocationNortheast Florida Health Services Dba Family Health Source1205 S Woodland Blvd Ste 4, Deland, FL 32720
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Florida Health Services, Inc.'s NPI number?

The NPI number for Northeast Florida Health Services, Inc. is 1164196861. It was assigned to this organization in the NPPES registry on August 5, 2021. The provider is doing business as Family Health Source.

Where is Northeast Florida Health Services, Inc. located?

Northeast Florida Health Services, Inc. is located at 1200 Deltona Blvd Ste 40A, Deltona, FL 32725. The listed phone number is (386) 202-6025.

What is Northeast Florida Health Services, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Does Northeast Florida Health Services, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1026293) is associated with this NPI, valid through June 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northeast Florida Health Services, Inc. was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.