Healthcare Provider Details

I. General information

NPI: 1841046992
Provider Name (Legal Business Name): TURQUISHA M PEACOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13614 SPRUCE PINE DR
WESTLAKE FL
33470-2043
US

IV. Provider business mailing address

13614 SPRUCE PINE DR
WESTLAKE FL
33470-2043
US

V. Phone/Fax

Practice location:
  • Phone: 305-450-9309
  • Fax: 561-484-1868
Mailing address:
  • Phone: 305-450-9309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number202608822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: