Provider Demographics
NPI:1336326347
Name:SEDAN INC
Entity Type:Organization
Organization Name:SEDAN INC
Other - Org Name:TREASURE COAST CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFTOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-684-1080
Mailing Address - Street 1:6901 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE D7
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2511
Mailing Address - Country:US
Mailing Address - Phone:561-684-1080
Mailing Address - Fax:561-684-6221
Practice Address - Street 1:6901 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE D7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2511
Practice Address - Country:US
Practice Address - Phone:561-684-1080
Practice Address - Fax:561-684-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74999OtherBCBSFL
FL74999OtherBCBSFL