Healthcare Provider Details

I. General information

NPI: 1962892026
Provider Name (Legal Business Name): JAMES VALCARCEL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 03/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 N ORCHARD ST SUITE 3
ORMOND BEACH FL
32174-9534
US

IV. Provider business mailing address

136 N ORCHARD ST SUITE 3
ORMOND BEACH FL
32174-9534
US

V. Phone/Fax

Practice location:
  • Phone: 386-310-8096
  • Fax: 386-866-0292
Mailing address:
  • Phone: 386-310-8096
  • Fax: 386-866-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 11415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: