Provider Demographics
NPI:1528150349
Name:CARTALES, MICHAEL PHILLIP (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PHILLIP
Last Name:CARTALES
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 1:1712 CAPE CORAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9620
Mailing Address - Country:US
Mailing Address - Phone:239-540-5433
Mailing Address - Fax:239-549-3376
Practice Address - Street 1:1712 CAPE CORAL PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9620
Practice Address - Country:US
Practice Address - Phone:239-540-5433
Practice Address - Fax:239-549-3376
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH20473OtherANTHEM BCBS
OH0811581Medicaid
OH20473OtherANTHEM BCBS
OH0811581Medicaid