Devereux | |
5850 T G Lee Blvd Suite 400 Orlando FL 32822-4407 | |
(321) 281-3840 | |
Not Available |
Full Name | Devereux |
---|---|
Speciality | Clinic/center - Community Health |
Location | 5850 T G Lee Blvd, Orlando, Florida |
Authorized Official Name and Position | Jacquita Elston (THERAPIST) |
Authorized Official Contact | 3212813840 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Devereux 1010 Executive Center Dr Suite 100 Orlando FL 32803-3529 Ph: () - | Devereux 5850 T G Lee Blvd Suite 400 Orlando FL 32822-4407 Ph: (321) 281-3840 |
NPI Number | 1326301706 |
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Provider Enumeration Date | 06/20/2012 |
Last Update Date | 06/20/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326301706 | NPI | - | NPPES |
029573621 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | 160994624 (Florida) | Primary |
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