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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 : 1831047166
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 : 160 CYPRESS POINT PKWY STE B205
Second Line :
City : PALM COAST
State : FL
Zip : 32164-8437
Country : US
Telephone Number : 386-873-0365
Fax Number : 386-868-1929
Authorized Official
Title or Position : CFO
Name : MS. RIKESHA BLAKE
Credential :
Telephone Number : 407-287-5185
Provider Enumeration Date : 03/20/2026
Last Update Date : 04/06/2026

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