Healthcare Provider Details

I. General information

NPI: 1750198693
Provider Name (Legal Business Name): DESIREEH NIKOLE CHEVERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301A W PALMETTO PARK RD STE 100C
BOCA RATON FL
33433-3403
US

IV. Provider business mailing address

1243 SW 44TH TER
DEERFIELD BEACH FL
33442-8263
US

V. Phone/Fax

Practice location:
  • Phone: 954-248-1171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: