Victoria Michele Dewaters

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

8790 53Rd Way N
Pinellas Park, FL 33782-5180

Phone

(727) 804-1442

Fax

(727) 491-5508

NPI assigned

May 20, 2021

Last updated

Jun 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avica, LLC

  dba West Coast Support Services

  • Developmentally Disabled Services Day Training Agency
  • Pinellas Park, FL
  • NPI 1427568724

  Case Management

  NPD Authorized official

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1326613589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337800101",
            "telephone_number": "727-804-1442",
            "fax_number": "727-491-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8790 53RD WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337825180",
            "telephone_number": "727-804-1442",
            "fax_number": "727-491-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWATERS",
        "first_name": "VICTORIA",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022082900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda A Alburquerque Desjardins, M.S., BCBA
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• Jameson Detmer
• Diabetes Thyroid and Endocrinology Associates LLC
• Dayana Diaz Falcon
• Melissa Dicaro, MSW
• Tiffany L Dickert, B.S.
• Sarah Anne Digby, D.O.

• Developmentally Disabled Services Day Training Agency in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.