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NPI Code Detail

MEDICARE: JERCOBY DEMIN WALKER

MEDICARE: JERCOBY DEMIN WALKER
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
1106S00000XBehavior TechnicianW426424022810FL

General Provider Information

NPI Number : 1811851850
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERCOBY DEMIN WALKER
Provider Business Mailing Address
First Line : 2145 ANGEL FISH LOOP
Second Line :
City : LEESBURG
State : FL
Zip : 34748-6162
Country : US
Telephone Number : 352-255-9534
Fax Number :
Provider Business Practice Location Address
First Line : 606 S 9TH ST
Second Line :
City : LEESBURG
State : FL
Zip : 34748-6320
Country : US
Telephone Number : 352-255-9534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ JERCOBY DEMIN WALKER ” Practice Location

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