Provider Demographics
NPI:1780981936
Name:DAUGHERTY, CALEB HUNTER (DC, RN)
Entity type:Individual
Prefix:DR
First Name:CALEB
Middle Name:HUNTER
Last Name:DAUGHERTY
Suffix:
Gender:M
Credentials:DC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7801 SW 24TH ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6538
Mailing Address - Country:US
Mailing Address - Phone:786-459-9015
Mailing Address - Fax:866-532-0839
Practice Address - Street 1:7801 SW 24TH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6538
Practice Address - Country:US
Practice Address - Phone:786-459-9015
Practice Address - Fax:866-532-0839
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH10107111N00000X
FLRN9428382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFK953ZMedicare UPIN