Provider Demographics
NPI:1952659252
Name:THE DEVEREUX FOUNDATION
Entity Type:Organization
Organization Name:THE DEVEREUX FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-362-9210
Mailing Address - Street 1:6314 CORPORATE CT
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3516
Mailing Address - Country:US
Mailing Address - Phone:239-690-5200
Mailing Address - Fax:
Practice Address - Street 1:6314 CORPORATE CT
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3516
Practice Address - Country:US
Practice Address - Phone:239-690-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-17
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100020550261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health