Provider Demographics
NPI:1538489398
Name:AMODEO, DEBORAH NEVILLE
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:NEVILLE
Last Name:AMODEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2418
Mailing Address - Country:US
Mailing Address - Phone:904-249-1065
Mailing Address - Fax:
Practice Address - Street 1:632 15TH ST N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-2418
Practice Address - Country:US
Practice Address - Phone:904-249-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist