Provider Demographics
NPI:1275551426
Name:ESTEVEZ, VICTOR (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:ESTEVEZ
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 1:8239 SW 124TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5939
Mailing Address - Country:US
Mailing Address - Phone:305-234-4725
Mailing Address - Fax:305-234-4752
Practice Address - Street 1:12177 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5257
Practice Address - Country:US
Practice Address - Phone:305-234-4725
Practice Address - Fax:305-234-4752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0008638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL297820OtherAVMED
FL89129OtherBLUE CROSS BLUE SHIELD
FL89129OtherBLUE CROSS BLUE SHIELD
FLU98245Medicare UPIN