Healthcare Provider Details

I. General information

NPI: 1407424906
Provider Name (Legal Business Name): ACCESSIBILITY CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2021
Last Update Date: 06/12/2021
Certification Date: 06/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 SELBYDON WAY
WINTER GARDEN FL
34787-4652
US

IV. Provider business mailing address

1357 SELBYDON WAY
WINTER GARDEN FL
34787-4652
US

V. Phone/Fax

Practice location:
  • Phone: 352-536-4981
  • Fax:
Mailing address:
  • Phone: 352-536-4981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY S DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 352-536-4981