Individual
MRS. DEVADAH LA JEUNE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1296 W BROAD ST, GROVELAND, FL 34736-2012
(407) 905-8827
(352) 429-5606
Mailing address
110 S WOODLAND ST, WINTER GARDEN, FL 34787-3546
(407) 905-8827
(407) 905-8998
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9218029
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9218029
FL
363LP0200X
Pediatric Nurse Practitioner
ARNP9218029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022286700
—
FL
Enumeration date
05/24/2017
Last updated
12/15/2023
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