| Dr Iris M Dejesus, D C | |
|
6303 Sw 40th Street, Miami, FL 33155 | |
| (305) 661-4989 | |
| (305) 661-9324 |
| Full Name | Dr Iris M Dejesus |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 6303 Sw 40th Street, Miami, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285850602 | NPI | - | NPPES |
| 39619 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH0005327 (Florida) | Primary |
| Provider Name | Excel Medical Diagnostics 1 , Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1568985281 PECOS PAC ID: 4880022342 Enrollment ID: O20200316001027 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Iris M Dejesus, D C 6303 Sw 40th Street, Miami, FL 33155 Ph: (305) 661-4989 | Dr Iris M Dejesus, D C 6303 Sw 40th Street, Miami, FL 33155 Ph: (305) 661-4989 |
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