Provider Demographics
NPI:1528942984
Name:DERONVIL, WILKER
Entity type:Individual
Prefix:
First Name:WILKER
Middle Name:
Last Name:DERONVIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3767 LAKE WORTH RD STE 114
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4048
Mailing Address - Country:US
Mailing Address - Phone:561-486-9352
Mailing Address - Fax:561-408-1866
Practice Address - Street 1:3767 LAKE WORTH RD STE 114
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-4048
Practice Address - Country:US
Practice Address - Phone:561-486-9352
Practice Address - Fax:561-408-1866
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist