Healthcare Provider Details

I. General information

NPI: 1780512152
Provider Name (Legal Business Name): VICTORIA DEVILLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17670 NW 78TH AVE STE 206
HIALEAH FL
33015-3670
US

IV. Provider business mailing address

9025 NW 174TH LN
HIALEAH FL
33018-6681
US

V. Phone/Fax

Practice location:
  • Phone: 305-440-0785
  • Fax:
Mailing address:
  • Phone: 305-878-3574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: