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EASTERSEALS NORTHEAST CENTRAL FLORIDA NPI 1326183377


NPI Information

NPI: 1326183377
Provider Name: EASTERSEALS NORTHEAST CENTRAL FLORIDA
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
650 W NEW YORK AVE
DELAND, FL
ZIP 32720
Phone: (386) 255-4568
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EASTERSEALS NORTHEAST CENTRAL FLORIDA is a clinic center in Deland, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). EASTERSEALS NORTHEAST CENTRAL FLORIDA NPI is 1326183377. The provider is registered as an organization entity type.

The provider's business location address is:

650 W NEW YORK AVE
DELAND, FL
ZIP 32720-239
Phone: (386) 255-4568
Fax: (386) 258-7677

The provider's authorized official is Beverly Johnson .
The authorized official title is Ceo and has the following contact phone number (386) 255-4568.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 4/3/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center34167FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18907811 00MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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