Provider Demographics
NPI:1508447459
Name:RINCON, JOSE R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:RINCON
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 1:12480 ORANGE GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8930
Mailing Address - Country:US
Mailing Address - Phone:561-537-0260
Mailing Address - Fax:
Practice Address - Street 1:3927 S JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-1511
Practice Address - Country:US
Practice Address - Phone:561-331-8398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor