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NPI Code Detail

MEDICARE: THE DEVEREUX FOUNDATION

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
1261QC1500XCommunity Health 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 : 1578740635
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE DEVEREUX FOUNDATION
Provider Business Mailing Address
First Line : 5850 T G LEE BLVD STE 400
Second Line :
City : ORLANDO
State : FL
Zip : 32822-4409
Country : US
Telephone Number : 407-362-9274
Fax Number :
Provider Business Practice Location Address
First Line : 6131 CHRISTIAN WAY
Second Line :
City : ORLANDO
State : FL
Zip : 32808-1435
Country : US
Telephone Number : 407-296-5300
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MICHAEL C BECKER
Credential :
Telephone Number : 407-362-9210
Provider Enumeration Date : 01/30/2008
Last Update Date : 10/22/2025

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Directions to “THE DEVEREUX FOUNDATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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