Provider Demographics
NPI:1508979014
Name:RHODES, STEVEN LLOYD (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LLOYD
Last Name:RHODES
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 1:320 FIRST ST N.
Mailing Address - Street 2:SUITE 709
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250
Mailing Address - Country:US
Mailing Address - Phone:904-270-2790
Mailing Address - Fax:904-270-2715
Practice Address - Street 1:320 1ST ST N
Practice Address - Street 2:SUITE 709
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6944
Practice Address - Country:US
Practice Address - Phone:904-270-2790
Practice Address - Fax:904-270-2715
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88697,88697A,88697BMedicare ID - Type Unspecified
FLT55927Medicare UPIN