Michael David Deveau, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

ME131282 Issued in FL

Practice address

308 Kingsley Lake Dr Ste 802
Saint Augustine, FL 32092-3046

Phone

(904) 342-0438

NPI assigned

Apr 2, 2013

Last updated

May 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2025 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Power Spine & Pain

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  • NPI 1558133694
  Authorized official Same address or phone
• Total Health of Wesley Chapel Inc

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  NPD
• Microspine Physicians Group LLC

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  • NPI 1356396774
  NPD (past)
• Southlake Family Practice PA

  • Primary Care Clinic/Center
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  • NPI 1225247810
  NPD (past)
• Vip Neurology

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  NPD (past)
• Physician Partners of America Crna Operations LLC

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  • Hurst, TX
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  NPD (past)

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1528301132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 KINGSLEY LAKE DR STE 802",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923046",
            "telephone_number": "904-342-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 KINGSLEY LAKE DR STE 802",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923046",
            "telephone_number": "904-342-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8318 N Habana Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33614",
            "country_code": "US",
            "telephone_number": "813-667-2460",
            "fax_number": "813-667-2461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6496 N US Highway 41",
            "address_purpose": "LOCATION",
            "city": "Apollo Beach",
            "state": "FL",
            "postal_code": "335721804",
            "country_code": "US",
            "telephone_number": "813-667-2460",
            "fax_number": "813-667-2461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Jenks Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054740",
            "country_code": "US",
            "telephone_number": "855-527-7246",
            "fax_number": "833-810-1165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVEAU",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "FL",
            "license": "ME131282",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME131282",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME131282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13880301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vinod Deshmukh, M.D., PH.D.
• Rodnika Desmore
• Godlive Desravines, APRN
• Jacob Matheny Desuyo, DSL, BCBA
• Tara Lovett Dettra, L.M., C.P.M.
• Jennifer Deverin
• Valerie Catherine Deville, LMHC
• John Devlin
• Laurie A Dewitt, C.R.N.A.
• Vijayselwyn Davis Dhas, M.D.

• Interventional Pain Medicine Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.