| The Devereux Foundation | |
|
1850 S Deleon Ave Titusville FL 32780-7733 | |
| (407) 374-2827 | |
| Not Available |
| Full Name | The Devereux Foundation |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1850 S Deleon Ave, Titusville, Florida |
| Authorized Official Name and Position | Gwen Skinner (VICE PRESIDENT OF OPERATIONS) |
| 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 Boulevard Suite 400 Orlando FL 32822 Ph: (407) 812-4555 | The Devereux Foundation 1850 S Deleon Ave Titusville FL 32780-7733 Ph: (407) 374-2827 |
| NPI Number | 1942369277 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 11/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942369277 | NPI | - | NPPES |
| 029573615 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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