Provider Demographics
NPI:1215990676
Name:JAFFE, DAVID ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:JAFFE
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 1:9468 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4150
Mailing Address - Country:US
Mailing Address - Phone:407-658-6500
Mailing Address - Fax:407-277-2690
Practice Address - Street 1:9468 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4150
Practice Address - Country:US
Practice Address - Phone:407-658-6500
Practice Address - Fax:407-277-2690
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051000200Medicaid
FLU39979Medicare UPIN
FL22446Medicare ID - Type Unspecified