MEDICARE: DR. JONATHAN REYES CARTAGENA

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	CH15270	FL

General Provider Information

NPI Number	:	1881400844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN REYES CARTAGENA

Provider Business Mailing Address
First Line	:	5410 S WILLIAMSON BLVD APT 6-104
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-7368
Country	:	US
Telephone Number	:	787-362-8584
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 S WILLIAMSON BLVD APT 6-104
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-7368
Country	:	US
Telephone Number	:	787-362-8584
Fax Number	:

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

Provider Enumeration Date	:	12/05/2024
Last Update Date	:	12/05/2024

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Directions to “ DR. JONATHAN REYES CARTAGENA ” Practice Location

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