Provider Demographics
NPI:1982203543
Name:NAFTEL, WILLIAM JESSE
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JESSE
Last Name:NAFTEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 HIGHWAY 98 E STE 9
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2588
Mailing Address - Country:US
Mailing Address - Phone:850-460-2362
Mailing Address - Fax:
Practice Address - Street 1:981 HIGHWAY 98 E STE 9
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2588
Practice Address - Country:US
Practice Address - Phone:850-460-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty