EASTERSEALS NORTHEAST CENTRAL FLORIDA INC. NPI 1992406607

NPI Information

  • NPI: 1992406607
  • Provider Name: EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
  • Classification: Pediatrics - 2080P0006X
  • Specialization: Developmental - Behavioral Pediatrics
  • Entity Type: Organization
  • Address: 3804 PIONEER TRL
    NEW SMYRNA BEACH, FL
    ZIP 32168
  • Phone: (386) 944-7805

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NPI Details

EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC. is a developmental - behavioral pediatrics pediatrics in New Smyrna Beach, FL. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC. NPI is 1992406607. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3804 PIONEER TRL
NEW SMYRNA BEACH, FL
ZIP 32168-784
Phone: (386) 944-7805
Fax: (386) 258-7677

The provider's authorized official is Michele Wallens .
The authorized official title is Accounting Manager and has the following contact phone number (386) 255-4568.

The enumeration date for this NPI number is 3/10/2023 and was last updated on 3/10/2023.

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
12080P0006XPediatricsDevelopmental - Behavioral PediatricsYes

What is NPI?

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This page was last updated on: 11/21/2025

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