# DEVEREUX

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

## Provider details

- **NPI number:** 1962835686
- **Authorized official:** VICKY HERRICK M.A. (CLINICIAN)
- **Authorized official phone:** (407) 963-7873

## Contact information

- **Practice address:** 1010 EXECUTIVE CENTER DR, ORLANDO, FL 32803-3529
- **Practice address phone:** (407) 367-1665
- **Mailing address:** 5850 T G LEE BLVD, ORLANDO, FL 32822-4407

## Taxonomy

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

## Other

- **Enumeration date:** 08/16/2013
- **Last updated:** 08/16/2013