Healthcare Provider Details

I. General information

NPI: 1922210509
Provider Name (Legal Business Name): KELLEY JUNE DETURO M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 02/25/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 US HWY 441 SUITE B3
FRUITLAND PARK FL
34731-4497
US

IV. Provider business mailing address

13124 S SUNSET TER
WINTER GARDEN FL
34787-9675
US

V. Phone/Fax

Practice location:
  • Phone: 352-323-0612
  • Fax:
Mailing address:
  • Phone: 407-654-2686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: