Provider Demographics
NPI:1639057672
Name:AEGIS CARE SERVICES
Entity type:Organization
Organization Name:AEGIS CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEDRICK
Authorized Official - Middle Name:DEANDRA
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FNP-BC
Authorized Official - Phone:904-477-3138
Mailing Address - Street 1:3363 DIONE ST
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-7582
Mailing Address - Country:US
Mailing Address - Phone:904-477-3138
Mailing Address - Fax:
Practice Address - Street 1:1133 TORRINGTON ST SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-7334
Practice Address - Country:US
Practice Address - Phone:904-477-3138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services