MEDICARE: THE DEVEREUX FOUNDATION

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	261QC1500X	Community Health Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1528446887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DEVEREUX FOUNDATION

Provider Business Mailing Address
First Line	:	5850 T G LEE BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4407
Country	:	US
Telephone Number	:	407-362-9274
Fax Number	:	866-440-0613

Provider Business Practice Location Address
First Line	:	5850 T G LEE BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4407
Country	:	US
Telephone Number	:	407-362-9274
Fax Number	:	866-440-0613

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	STEVEN J MURPHY
Credential	:
Telephone Number	:	407-362-9210

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	05/07/2015

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Directions to “THE DEVEREUX FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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