Dieumy Duclos
Individual provider Active NPI Behavior Technician · Lynn Haven, FL
NPI 1811348113 · NPPES record last updated Mar 13, 2019
Key facts
- NPI
- 1811348113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 3960 Arbor Trace Dr Unit B
Lynn Haven, FL 32444-6723 - Phone
- (855) 832-6727
- Fax
- (772) 675-9100
- NPI assigned
- Jun 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
3960 Arbor Trace Dr Unit B
Lynn Haven, FL 32444-6723
Mailing address
4575 SE Dixie Hwy
Stuart, FL 34997-6826
Other practice location 1
1000 W Broadway St Ste 214
Oviedo, FL 32765-9262
Phone (407) 359-5693
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019454500 | Medicaid | FL |
Other providers in Lynn Haven, FL
- Christina M Deegins
- Derek H. Wall DDS PA
- Robert Joseph Doheny Jr.
- Daphne Downard
- Dr David Huston OD PA
- Tong C. Duong
- Emerald Coast Rheumatology LLC
- Emerald Coast Walk in Clinic LLC
- Emerald Shores Chiropractic LLC
- Frederick B Epstein
All providers in Lynn Haven, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.