Individual provider Active NPI

Deona Berna Glover

  • Phlebotomy Technician
  • Leesburg, FL
National Provider Identifier
1861844417
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
20-0056R14 Issued in FL
Practice address
2533 Sennett Dr
201
Leesburg, FL 34748-7291
Phone
(352) 874-0432
NPI assigned
Jul 7, 2016
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X 20-0056R14 FL Primary

Addresses

Primary practice location

2533 Sennett Dr
201
Leesburg, FL 34748-7291

Mailing address

PO Box 882
Fruitland Park, FL 34731-0882
Phone (352) 874-0432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20-0056R14FLMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1861844417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347310882",
            "telephone_number": "352-874-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 SENNETT DR",
            "address_2": "201",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487291",
            "telephone_number": "352-874-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "DEONA",
        "middle_name": "BERNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "FL",
            "license": "20-0056R14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

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