MEDICARE: DERRICA LATRECE CURTIS

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
1	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1477422335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERRICA LATRECE CURTIS

Provider Business Mailing Address
First Line	:	3332 SOUTEL DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-1349
Country	:	US
Telephone Number	:	904-465-2108
Fax Number	:	904-465-2108

Provider Business Practice Location Address
First Line	:	3332 SOUTEL DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-1349
Country	:	US
Telephone Number	:	904-465-2108
Fax Number	:	904-465-2108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	01/12/2026

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Directions to “ DERRICA LATRECE CURTIS ” Practice Location

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