| Devereux Florida | |
|
1010 Executive Center Dr 100 Orlando FL 32803-3529 | |
| (321) 281-3840 | |
| Not Available |
| Full Name | Devereux Florida |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1010 Executive Center Dr, Orlando, Florida |
| Authorized Official Name and Position | Jose R Mendoza (THERAPIST) |
| Authorized Official Contact | 3212813840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Devereux Florida 1010 Executive Center Dr 100 Orlando FL 32803-3529 Ph: (321) 281-3840 | Devereux Florida 1010 Executive Center Dr 100 Orlando FL 32803-3529 Ph: (321) 281-3840 |
| NPI Number | 1366704074 |
|---|---|
| Provider Enumeration Date | 06/10/2012 |
| Last Update Date | 06/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366704074 | NPI | - | NPPES |
| 029573621 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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