Provider Portal - Forgot Password

Call: 866-389-0211


 
Please enter your username and an EIN which you are affiliated with.
We will then send you information on how to proceed.
User Name:   
EIN:   (numbers only)  
Regenerate Numbers
(Please enter the 5 numbers displayed above.)
 

841 Prudential Dr., Suite 204 Jacksonville, FL 32207  |  Phone Toll Free: 866-389-0211  |  Fax: 904-998-0299
Release Date: 1/6/2023 1:28:04 PM