MEDICARE: LIV WELL CHIROPRACTIC, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1396602637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIV WELL CHIROPRACTIC, P.A.

Provider Business Mailing Address
First Line	:	2146 S RIVERSIDE DR STE 5
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32141-4257
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2146 S RIVERSIDE DR STE 5
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32141-4257
Country	:	US
Telephone Number	:	386-222-0210
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OLIVIA EVANS
Credential	:	D.C.
Telephone Number	:	386-222-0210

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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