Organization
EASTERSEALS NORTHEAST CENTRAL FLORIDA
Active
Other names
Easter Seals of Volusia and Flagler
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY JOHSNON (CEO)
(386) 255-4568
Entity
Organization
Contact information
Practice address
1219 DUNN AVE, DAYTONA BEACH, FL 32114
(386) 255-4568
(386) 252-3403
Mailing address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
(386) 252-3403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880172000
—
FL
Enumeration date
06/14/2007
Last updated
04/03/2023
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