# DEVEREUX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326301706
- **Authorized official:** JACQUITA ELSTON (THERAPIST)
- **Authorized official phone:** (321) 281-3840

## Contact information

- **Practice address:** 5850 T G LEE BLVD, SUITE 400, ORLANDO, FL 32822-4407
- **Practice address phone:** (321) 281-3840
- **Mailing address:** 1010 EXECUTIVE CENTER DR, SUITE 100, ORLANDO, FL 32803-3529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 160994624 | FL | Yes |

## Other

- **Enumeration date:** 06/20/2012
- **Last updated:** 06/20/2012