MEDICARE: DR. KALE DEWEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12854	FL

General Provider Information

NPI Number	:	1063064467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KALE DEWEY

Provider Business Mailing Address
First Line	:	2040 RUNNING HORSE TRL
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-7313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 ALEXANDRIA BLVD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-5548
Country	:	US
Telephone Number	:	407-977-3434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2019
Last Update Date	:	09/27/2021

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Directions to “ DR. KALE DEWEY ” Practice Location

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