Provider Demographics
NPI:1518937655
Name:CLEVELAND, JASON ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ADAM
Last Name:CLEVELAND
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 1:6089 BEACONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6801
Mailing Address - Country:US
Mailing Address - Phone:561-868-0621
Mailing Address - Fax:
Practice Address - Street 1:4332 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5718
Practice Address - Country:US
Practice Address - Phone:561-965-2500
Practice Address - Fax:561-965-0708
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70162AMedicare ID - Type UnspecifiedMEDICAIRE ID
FL70162Medicare ID - Type UnspecifiedMEDICAIRE ID : POMPANO