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General NPI Number Information
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NPI Number | 1447083118
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Entity Type | Organization
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Legal Business Name | EASTER SEALS FLORIDA, INC.
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 31600 CAMP CHALLENGE RD
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City | SORRENTO
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State | FL
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Zip | 32776-9558
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Country | US
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Telephone | 352-383-4711
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Fax | 352-383-0744
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Provider Business Mailing Address
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Address Line | 2010 CROSBY WAY
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City | WINTER PARK
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State | FL
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Zip | 32792-4119
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Country | US
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Telephone | 407-629-7881
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Fax | 407-629-4754
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Authorized Official
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Title or Position | CFO
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Name | RIKESHA BLAKE
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Credential |
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Telephone | 407-287-5185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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