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NPI Code Detail

MEDICARE: EASTERSEALS FLORIDA, INC.

MEDICARE: EASTERSEALS 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
1261Q00000XClinic/Center
2251B00000XCase Management Agency

General Provider Information

NPI Number : 1811835515
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERSEALS FLORIDA, INC.
Provider Business Mailing Address
First Line : 125 N RIDGEWOOD AVE STE 300
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-3284
Country : US
Telephone Number : 386-944-7802
Fax Number :
Provider Business Practice Location Address
First Line : 5650 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7312
Country : US
Telephone Number : 321-634-3688
Fax Number :
Authorized Official
Title or Position : CFO
Name : RIKESHA BLAKE
Credential :
Telephone Number : 407-287-5185
Provider Enumeration Date : 03/23/2026
Last Update Date : 04/06/2026

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