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NPI Code Detail

MEDICARE: ABIGAIL ELISE DEATON

MEDICARE:   ABIGAIL ELISE DEATON
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
1106S00000XBehavior TechnicianRBT-22-243127NC

General Provider Information

NPI Number : 1508578196
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL ELISE DEATON
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 2407 PLANTATION CENTER DR STE 100
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-5418
Country : US
Telephone Number : 984-275-3054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2022
Last Update Date : 06/04/2024

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Directions to “ ABIGAIL ELISE DEATON ” Practice Location

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