Organization
THE DEVEREUX FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN SKINNER (EXECUTIVE DIRECTOR)
(407) 362-9213
Entity
Organization
Contact information
Practice address
120 E NEW YORK AVE, DELAND, FL 32724-5568
(386) 738-5543
Mailing address
5850 T G LEE BLVD, ORLANDO, FL 32822-4407
(407) 362-9213
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029573612
—
FL
Enumeration date
04/12/2007
Last updated
10/04/2018
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