Provider Demographics
NPI:1811773690
Name:SEMIDEY, ISMAEL JOEL (DC)
Entity type:Individual
Prefix:DR
First Name:ISMAEL
Middle Name:JOEL
Last Name:SEMIDEY
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 1:1200 FLORAL SPRINGS BLVD UNIT 29307
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-6854
Mailing Address - Country:US
Mailing Address - Phone:787-673-2889
Mailing Address - Fax:
Practice Address - Street 1:521 N KIRKMAN RD # 130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7644
Practice Address - Country:US
Practice Address - Phone:407-440-4658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor