Provider Demographics
NPI:1770861114
Name:CHERKEZIAN, JUAN CARLOS (DOM, AP)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:CHERKEZIAN
Suffix:
Gender:M
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 NW 2ND AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1627
Mailing Address - Country:US
Mailing Address - Phone:561-361-8577
Mailing Address - Fax:561-361-4427
Practice Address - Street 1:1612 NW 2ND AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1627
Practice Address - Country:US
Practice Address - Phone:561-361-8577
Practice Address - Fax:561-361-4427
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist