Healthcare Provider Details

I. General information

NPI: 1942116744
Provider Name (Legal Business Name): JUSTIN MAX SANTANA FELICIANO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 SE MARICAMP RD
OCALA FL
34472-2343
US

IV. Provider business mailing address

230 SANDS PARC BLVD APT 209
DAYTONA BEACH FL
32117-0050
US

V. Phone/Fax

Practice location:
  • Phone: 407-434-7246
  • Fax:
Mailing address:
  • Phone: 787-543-2592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: