Provider Demographics
NPI:1760023477
Name:DE JESUS, HECTOR LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:LOUIS
Last Name:DE JESUS
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 1:822 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7820
Mailing Address - Country:US
Mailing Address - Phone:407-630-7749
Mailing Address - Fax:
Practice Address - Street 1:822 MERCY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7820
Practice Address - Country:US
Practice Address - Phone:407-630-7749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor