Provider Demographics
NPI:1316125370
Name:CADAVEDO-GARCIA, JOSE RAMON (DC)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAMON
Last Name:CADAVEDO-GARCIA
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 1:310 S DILLARD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3515
Mailing Address - Country:US
Mailing Address - Phone:407-347-5953
Mailing Address - Fax:407-614-5911
Practice Address - Street 1:310 S DILLARD ST STE 200
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3515
Practice Address - Country:US
Practice Address - Phone:407-347-5953
Practice Address - Fax:407-614-5911
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89107OtherBCBS