Provider Demographics
NPI:1053956821
Name:JALDIN, MARCELO
Entity type:Individual
Prefix:DR
First Name:MARCELO
Middle Name:
Last Name:JALDIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6202 SOLSTICE LOOP
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-0062
Mailing Address - Country:US
Mailing Address - Phone:703-929-2831
Mailing Address - Fax:
Practice Address - Street 1:4125 HUNTERS PARK LN STE 117
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7615
Practice Address - Country:US
Practice Address - Phone:407-930-1678
Practice Address - Fax:863-353-6145
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor