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General NPI Number Information
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NPI Number | 1336444371
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Entity Type | Individual
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Provider Name | JOSE ANDRES DEVESA D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 878 N MIRAMAR AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3054
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Country | US
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Telephone | 321-676-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 878 N MIRAMAR AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3054
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Country | US
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Telephone | 352-538-9768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH10213
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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