Provider Demographics
NPI:1225298995
Name:CERVERA, RAPHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:
Last Name:CERVERA
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 1:13838 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6061
Mailing Address - Country:US
Mailing Address - Phone:305-380-6296
Mailing Address - Fax:305-380-6298
Practice Address - Street 1:13838 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6061
Practice Address - Country:US
Practice Address - Phone:305-380-6296
Practice Address - Fax:305-380-6298
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor