=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851455992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE DEVEREUX FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2006
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9301 NE 6TH AVE
-----------------------------------------------------
City | MIAMI SHORES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33138-2855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-463-9967
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5850 T G LEE BLVD STE 400
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32822-4409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-812-4555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | STEVEN J MURPHY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-812-4555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------