Provider Demographics
NPI:1962637744
Name:KIDD, DAVID JAMES (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:KIDD
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 1:190 NE 199TH ST #203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179
Mailing Address - Country:US
Mailing Address - Phone:305-493-8734
Mailing Address - Fax:305-493-8736
Practice Address - Street 1:190 NE 199TH ST STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2927
Practice Address - Country:US
Practice Address - Phone:305-493-8734
Practice Address - Fax:305-493-8734
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7050111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation