Image Chiropractic Re-Hab LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH8452 Issued in FL

Legal business name

IMAGE CHIROPRACTIC RE-HAB LLC

Practice address

4048 Evans Ave Ste 208
Fort Myers, FL 33901-9385

Phone

(239) 362-3111

NPI assigned

Apr 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jude Henry Valles, DC

Title

Physician

Phone

(561) 707-1798

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1477907079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE STE 208",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019385",
            "telephone_number": "239-362-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE STE 208",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019385",
            "telephone_number": "239-362-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE CHIROPRACTIC RE-HAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "VALLES",
        "authorized_official_first_name": "JUDE",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "561-707-1798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH8452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Rehabilitation Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.