Provider Demographics
NPI:1124078035
Name:PLATT, JOHN KEVIN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEVIN
Last Name:PLATT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-5918
Mailing Address - Country:US
Mailing Address - Phone:863-763-2400
Mailing Address - Fax:863-763-2446
Practice Address - Street 1:280 SW 32ND ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974-5918
Practice Address - Country:US
Practice Address - Phone:863-763-2400
Practice Address - Fax:863-763-2446
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380505100Medicaid
FL22672OtherBCBS
FLU20801Medicare UPIN
FL380505100Medicaid