Healthcare Provider Details

I. General information

NPI: 1699684167
Provider Name (Legal Business Name): SUMMIT SPINE AND WELLNESS 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

8430 ENTERPRISE CIR STE 120
LAKEWOOD RANCH FL
34202-4111
US

IV. Provider business mailing address

8430 ENTERPRISE CIR STE 120
LAKEWOOD RANCH FL
34202-4111
US

V. Phone/Fax

Practice location:
  • Phone: 941-907-9663
  • Fax:
Mailing address:
  • Phone: 941-907-9663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA THOMAS MYERS
Title or Position: OWNER
Credential: DC
Phone: 941-907-9663