Provider Demographics
NPI:1194553594
Name:SAINT JACQUES, STAAFEE (DC)
Entity type:Individual
Prefix:
First Name:STAAFEE
Middle Name:
Last Name:SAINT JACQUES
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 1:2200 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-4526
Mailing Address - Country:US
Mailing Address - Phone:863-236-4722
Mailing Address - Fax:
Practice Address - Street 1:125 E MARKS ST FL 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3816
Practice Address - Country:US
Practice Address - Phone:407-271-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor