Healthcare Provider Details

I. General information

NPI: 1205608395
Provider Name (Legal Business Name): ADONICA'S SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W VOLUSIA AVE # 82
DELAND FL
32720-6651
US

IV. Provider business mailing address

820 W VOLUSIA AVE # 82
DELAND FL
32720-6651
US

V. Phone/Fax

Practice location:
  • Phone: 407-860-1501
  • Fax:
Mailing address:
  • Phone: 407-860-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224ZR0403X
TaxonomyDriving and Community Mobility Occupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. ADONICA NAKKEDA GRAY
Title or Position: PATIENT CARE TECHNICIAN/ LABORATORY
Credential:
Phone: 407-860-1501