NPIMap

Easterseals Northeast Central Florida, Inc.

Organization Active NPI Developmental - Behavioral Pediatrics Physician · New Smyrna Beach, FL

NPI 1992406607 · NPPES record last updated Mar 10, 2023

Key facts

NPI
1992406607
Entity type
Organization (NPI type 2)
Primary specialty
Developmental - Behavioral Pediatrics Physician 2080P0006X
Legal business name
EASTERSEALS NORTHEAST CENTRAL FLORIDA, INC.
Practice address
3804 Pioneer TRL
New Smyrna Beach, FL 32168-8784
Phone
(386) 944-7805
Fax
(386) 258-7677
NPI assigned
Mar 10, 2023
Organization subpart
No

Authorized official

Name
Ms. Michele Wallens
Title
Accounting Manager
Phone
(386) 255-4568

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Easter Seal Society (25 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2080P0006X Yes

Addresses

Primary practice location

3804 Pioneer TRL
New Smyrna Beach, FL 32168-8784

Mailing address

1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone (386) 944-7805

Other providers in New Smyrna Beach, FL

All providers in New Smyrna Beach, FL · Developmental - Behavioral Pediatrics Physician in Florida

Sources for this page

Verify at the official NPI Registry.