NPIMap

Easterseals Northeast Central Florida, Inc.

Organization Active NPI Multi-Specialty Clinic/Center · Bunnell, FL

NPI 1073387387 · NPPES record last updated Nov 8, 2023

Key facts

NPI
1073387387
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Practice address
3389 N State St Unit 1
Bunnell, FL 32110-4340
Phone
(386) 255-4568
Fax
(386) 258-7677
NPI assigned
Nov 8, 2023
Organization subpart
No

Authorized official

Name
Michele Wallens
Title
Accounting Manager
Phone
(386) 255-4568

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Easter Seal Society (25 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

3389 N State St Unit 1
Bunnell, FL 32110-4340

Mailing address

1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone (386) 944-7805

Other names

  • #MIP Other name

Other providers in Bunnell, FL

All providers in Bunnell, FL · Multi-Specialty Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.