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NPI Code Detail

MEDICARE: EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.

MEDICARE: EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist
3235Z00000XSpeech-Language Pathologist
4261QD1600XDevelopmental Disabilities Clinic/Center
5261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356045058
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Provider Business Mailing Address
First Line : 1219 DUNN AVE
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-2405
Country : US
Telephone Number : 386-944-7805
Fax Number :
Provider Business Practice Location Address
First Line : 3804 PIONEER TRL
Second Line :
City : NEW SMYRNA BEACH
State : FL
Zip : 32168-8784
Country : US
Telephone Number : 386-255-4568
Fax Number : 386-258-7677
Authorized Official
Title or Position : OFFICE MANAGER
Name : MARIA MONACO
Credential :
Telephone Number : 386-255-4568
Provider Enumeration Date : 03/28/2023
Last Update Date : 03/07/2025

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Practice Fax: 386-258-7677

Directions to “EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC. ” Practice Location

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