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General NPI Number Information
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NPI Number | 1750165718
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Entity Type | Individual
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Provider Name | JORGE JAVIER ZAYAS HENRIQUEZ DC
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Gender | Male
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 1770 S WOODLAND BLVD
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City | DELAND
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State | FL
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Zip | 32720-7915
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Country | US
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Telephone | 386-414-7440
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Fax |
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Provider Business Mailing Address
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Address Line | 8061 ALLURE CIR APT 621
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City | DEBARY
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State | FL
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Zip | 32713-2796
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Country | US
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Telephone | 787-587-8579
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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 | 14673
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License Number State | FL
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