Provider Demographics
NPI:1548692338
Name:DEYARMOND, ALBERT BRUCE (CAP)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:BRUCE
Last Name:DEYARMOND
Suffix:
Gender:M
Credentials:CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5664 SW 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5677
Mailing Address - Country:US
Mailing Address - Phone:352-291-5555
Mailing Address - Fax:352-291-9536
Practice Address - Street 1:3238 S LECANTO HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9025
Practice Address - Country:US
Practice Address - Phone:352-291-5555
Practice Address - Fax:352-291-9536
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP4494101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)