Healthcare Provider Details

I. General information

NPI: 1942980263
Provider Name (Legal Business Name): ODEVELYNE SAINT-SAUVEUR ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 ORANGE AVE STE 266
WINTER PARK FL
32789-4962
US

IV. Provider business mailing address

1350 ORANGE AVE STE 266
WINTER PARK FL
32789-4962
US

V. Phone/Fax

Practice location:
  • Phone: 321-370-2868
  • Fax:
Mailing address:
  • Phone: 321-370-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ODEVELYNE SAINT-SAUVEUR
Title or Position: CEO
Credential:
Phone: 321-370-2868