Provider Demographics
NPI:1437330222
Name:JEWELL, DENNIS M (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:JEWELL
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 1:579 S INDIANA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-3751
Mailing Address - Country:US
Mailing Address - Phone:941-474-4944
Mailing Address - Fax:941-475-8494
Practice Address - Street 1:579 S INDIANA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3751
Practice Address - Country:US
Practice Address - Phone:941-474-4944
Practice Address - Fax:941-475-8494
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT56384Medicare UPIN
FL89916Medicare PIN