Deyard Wellness Center

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

ME68224 Issued in FL

Legal business name

DEYARD WELLNESS CENTER

Practice address

1728 Dunlawton Ave
Ste 2
Port Orange, FL 32127-2922

Phone

(386) 322-3505

Fax

(386) 322-3509

NPI assigned

Aug 27, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laura Yard, MD

Title

VP

Phone

(386) 322-3505

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1306246319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 DUNLAWTON AVE",
            "address_2": "STE 2",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272922",
            "telephone_number": "386-322-3505",
            "fax_number": "386-322-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 DUNLAWTON AVE",
            "address_2": "STE 2",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272922",
            "telephone_number": "386-322-3505",
            "fax_number": "386-322-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEYARD WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "YARD",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "386-322-3505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "ME68224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Desena
• Vrushak Deshpande, M.D.
• Marie Denise Desir, P.A
• Evelyn Devine
• Olivia Dewey, PT, DPT
• Amrik Dhaliwal
• Diamond Heart Inc
• Diamond Heart Inc
• Amanda J Diaz, L.M.T.
• Paula Christina Dichiara, LMFT

• Exclusive Provider Organization in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.