Provider Demographics
NPI:1891765988
Name:DEEDS, DAYNE ALAN (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:DAYNE
Middle Name:ALAN
Last Name:DEEDS
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-3120
Mailing Address - Country:US
Mailing Address - Phone:321-408-0440
Mailing Address - Fax:
Practice Address - Street 1:1135 S WASHINGTON AVE STE B
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-8401
Practice Address - Country:US
Practice Address - Phone:321-408-0440
Practice Address - Fax:321-577-0200
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV04327Medicare UPIN
FL88909ZMedicare ID - Type Unspecified