Organization
THE DEVEREUX FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BECKER (EXECUTIVE DIRECTOR)
(407) 362-9210
Entity
Organization
Contact information
Practice address
442 GALLAGHER ST SW, PALM BAY, FL 32908-4727
(321) 409-2164
Mailing address
5850 TG LEE BLVD, ORLANDO, FL 32822-4407
(407) 362-9210
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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