Provider Demographics
NPI:1356665277
Name:BODEE, RAYMOND M (DC)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:M
Last Name:BODEE
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 1:2180 CENTRAL FLORIDA PKWY STE A5
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8900
Mailing Address - Country:US
Mailing Address - Phone:407-851-4593
Mailing Address - Fax:407-851-4595
Practice Address - Street 1:2180 CENTRAL FLORIDA PKWY STE A5
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8900
Practice Address - Country:US
Practice Address - Phone:407-851-4593
Practice Address - Fax:407-851-4593
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor