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NPI Code Detail

MEDICARE: DR. JOSE REINALDO HEREDIA D.C.

MEDICARE:  DR. JOSE REINALDO HEREDIA  D.C.
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
1111N00000XChiropractorCH 7044FL

General Provider Information

NPI Number : 1639233208
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE REINALDO HEREDIA D.C.
Provider Business Mailing Address
First Line : PO BOX 2358
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-2358
Country : US
Telephone Number : 407-240-9500
Fax Number : 407-240-9501
Provider Business Practice Location Address
First Line : 6236 KINGSPOINTE PKWY
Second Line : STE 9
City : ORLANDO
State : FL
Zip : 32819-6530
Country : US
Telephone Number : 407-240-9500
Fax Number : 407-240-9500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/22/2016

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Directions to “ DR. JOSE REINALDO HEREDIA D.C.” Practice Location

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