Provider Demographics
NPI:1184057804
Name:CHERESTAL, ROBINSON (DC)
Entity type:Individual
Prefix:
First Name:ROBINSON
Middle Name:
Last Name:CHERESTAL
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 1:4525 N PINE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-1952
Mailing Address - Country:US
Mailing Address - Phone:407-674-8719
Mailing Address - Fax:407-674-8727
Practice Address - Street 1:4525 N PINE HILLS RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-1952
Practice Address - Country:US
Practice Address - Phone:407-674-8719
Practice Address - Fax:407-674-8727
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor