Provider Demographics
NPI:1033848262
Name:PACHECO, JOSE F (DC)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:F
Last Name:PACHECO
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 1:10257 NW 9TH STREET CIR APT 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6643
Mailing Address - Country:US
Mailing Address - Phone:787-463-8707
Mailing Address - Fax:
Practice Address - Street 1:10257 NW 9TH STREET CIR APT 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-6643
Practice Address - Country:US
Practice Address - Phone:787-463-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor