Provider Demographics
NPI:1174585863
Name:PAGE, RAYMOND CHEW-ON (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CHEW-ON
Last Name:PAGE
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 1:6705 S RED RD
Mailing Address - Street 2:SUITE 702
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3622
Mailing Address - Country:US
Mailing Address - Phone:305-662-6433
Mailing Address - Fax:305-662-2762
Practice Address - Street 1:6705 S RED RD
Practice Address - Street 2:SUITE 702
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3622
Practice Address - Country:US
Practice Address - Phone:305-662-6433
Practice Address - Fax:305-662-2762
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381013500Medicaid
FL381013500Medicaid