Healthcare Provider Details

I. General information

NPI: 1184308512
Provider Name (Legal Business Name): ISLAND SPORTS CHIROPRACTIC & JOINT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99198 OVERSEAS HWY STE 8
KEY LARGO FL
33037-2437
US

IV. Provider business mailing address

99198 OVERSEAS HWY STE 8
KEY LARGO FL
33037-2437
US

V. Phone/Fax

Practice location:
  • Phone: 305-451-3337
  • Fax:
Mailing address:
  • Phone: 305-451-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSE JAMES SUESS
Title or Position: OWNER
Credential: DC
Phone: 862-432-1716