MEDICARE: DR. BRIAN CAEZ 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
1	111N00000X	Chiropractor	CH9448	FL
2	111NS0005X	Sports Physician Chiropractor	CH9448	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912184813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN CAEZ D.C.

Provider Business Mailing Address
First Line	:	PO BOX 21581
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-1581
Country	:	US
Telephone Number	:	813-872-4455
Fax Number	:	813-464-7756

Provider Business Practice Location Address
First Line	:	1001 N MACDILL AVE
Second Line	:	STE C
City	:	TAMPA
State	:	FL
Zip	:	33607-5152
Country	:	US
Telephone Number	:	813-872-4455
Fax Number	:	813-464-7756

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

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	06/17/2020

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Directions to “ DR. BRIAN CAEZ D.C.” Practice Location

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