NPIMap

Organization Active NPI

Devereux Foundation

  • Community Health Clinic/Center
  • Deland, FL
National Provider Identifier
1306904636
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
DEVEREUX FOUNDATION
Practice address
120 E New York Ave Ste C
Deland, FL 32724-5527
Phone
(386) 738-5543
NPI assigned
Dec 6, 2006
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Michael C Becker
Title
Executive Director
Phone
(407) 812-4555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

120 E New York Ave Ste C
Deland, FL 32724-5527

Mailing address

5850 T G Lee Blvd Ste 400
Orlando, FL 32822-4409
Phone (407) 812-4555

Other identifiers 1

IdentifierTypeStateIssuer
029573605MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Comm SVCS of Devereux332 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

120 E New York Ave
Ste C
Deland, FL 32724
Phone (386) 285-8046

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1306904636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 T G LEE BLVD STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224409",
            "telephone_number": "407-812-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E NEW YORK AVE STE C",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327245527",
            "telephone_number": "386-738-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-812-4555"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029573605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.