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General NPI Number Information
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NPI Number | 1144684978
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Entity Type | Organization
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Legal Business Name | CALEB H. DAUGHERTY
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 7801 SW 24TH ST SUITE 115
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City | MIAMI
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State | FL
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Zip | 33155-6538
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Country | US
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Telephone | 786-459-9015
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Fax | 305-532-0839
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Provider Business Mailing Address
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Address Line | 7801 SW 24TH ST SUITE 115
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City | MIAMI
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State | FL
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Zip | 33155-6538
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Country | US
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Telephone | 786-459-9015
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Fax | 305-532-0839
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Authorized Official
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Title or Position | DOCTOR / OWNER
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Name | DR. CALEB HUNTER DAUGHERTY
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Credential | D.C., RN
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Telephone | 786-459-9015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10107
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License Number State | FL
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