Healthcare Provider Details

I. General information

NPI: 1679437610
Provider Name (Legal Business Name): JENNIFER YVETTE CORVISON-TURBEVILLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 NW 39TH AVE STE 130-1020
GAINESVILLE FL
32606-7331
US

IV. Provider business mailing address

2470 N NINA TER
CRYSTAL RIVER FL
34428-5851
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 352-812-1041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberC612439545900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: