| The Devereux Foundation | |
|
1152 N University Dr Ste 200 Pembroke Pines FL 33024-5012 | |
| (954) 731-7665 | |
| Not Available |
| Full Name | The Devereux Foundation |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1152 N University Dr Ste 200, Pembroke Pines, Florida |
| Authorized Official Name and Position | Gwen Skinner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4073629210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Devereux Foundation 5850 T G Lee Blvd Suite 400 Orlando FL 32822-4407 Ph: (407) 812-4555 | The Devereux Foundation 1152 N University Dr Ste 200 Pembroke Pines FL 33024-5012 Ph: (954) 731-7665 |
| NPI Number | 1104980259 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 02/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104980259 | NPI | - | NPPES |
| 767753700 | Medicaid | FL | |
| 767753701 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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