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General NPI Number Information
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NPI Number | 1811835515
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Entity Type | Organization
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Legal Business Name | EASTERSEALS FLORIDA, INC.
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 5650 S WASHINGTON AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-7312
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Country | US
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Telephone | 321-634-3688
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Fax |
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Provider Business Mailing Address
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Address Line | 125 N RIDGEWOOD AVE STE 300
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3284
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Country | US
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Telephone | 386-944-7802
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Fax |
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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 | 261Q00000X
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Taxonomy Name | 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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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