MEDICARE: DESTINY SPEIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9503074	FL

General Provider Information

NPI Number	:	1346175205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY SPEIGHT

Provider Business Mailing Address
First Line	:	5080 NE 14TH PL
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-0839
Country	:	US
Telephone Number	:	940-206-5155
Fax Number	:

Provider Business Practice Location Address
First Line	:	5080 NE 14TH PL
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-0839
Country	:	US
Telephone Number	:	940-206-5155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ DESTINY SPEIGHT ” Practice Location

Language	Start Address	Practice Location

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