Devora Wheeler Patterson
Individual provider Active NPI Developmentally Disabled Services Day Training Agency · Williston, FL
NPI 1831409465 · NPPES record last updated Oct 17, 2010
Key facts
- NPI
- 1831409465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmentally Disabled Services Day Training Agency 251C00000X
- License
- 688535796 (FL)
- Practice address
- 21490 NE 37TH PL
Williston, FL 32696-7014 - Phone
- (352) 528-9442
- NPI assigned
- Oct 17, 2010
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 688535796 | FL | MD | Developmentally Disabled Services Day Training Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 688535796 | FL | Yes |
Addresses
Primary practice location
21490 NE 37TH PL
Williston, FL 32696-7014
Mailing address
21490 NE 37TH PL
Williston, FL 32696-7014
Phone (352) 528-9442
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 688535796 | Other | FL | MEDICAID PROVIDER ID NUMBER |
Other providers in Williston, FL
- Nature Coast Rehabilitation Inc
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- Chantal Marie Nichols
- Ocala Regional Physical Therapy Center
- Bipin V Patel
- Candace Penny
- Patricia Ann Perkins
- Phi 413, Inc Dba Good Samaritan Retirement Home
- Pry Inc
- Quality Care Transport Solutions
All providers in Williston, FL · Developmentally Disabled Services Day Training Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2010. 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.