Healthcare Provider Details
I. General information
NPI: 1134038474
Provider Name (Legal Business Name): ISLAND SPORTS CHIROPRACTIC & JOINT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 BARRACUDA LN
KEY LARGO FL
33037-3733
US
IV. Provider business mailing address
99198 OVERSEAS HWY STE 8
KEY LARGO FL
33037-2437
US
V. Phone/Fax
- Phone: 305-367-2600
- Fax:
- Phone: 305-461-3337
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JESSE
SUESS
Title or Position: OWNER
Credential: DC
Phone: 305-451-3337