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General NPI Number Information
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NPI Number | 1912860289
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Entity Type | Individual
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Provider Name | MAURICE DEAN
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Gender | Male
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3501 W VINE ST STE 115
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City | KISSIMMEE
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State | FL
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Zip | 34741-4644
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Country | US
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Telephone | 772-722-9470
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Fax |
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Provider Business Mailing Address
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Address Line | 1664 PONTIFF PL
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City | DAVENPORT
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State | FL
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Zip | 33896-8651
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Country | US
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Telephone | 608-960-0820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | FL
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