Healthcare Provider Details

I. General information

NPI: 1841113750
Provider Name (Legal Business Name): TRISTAN VASSBERG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 16TH AVE NW
NAPLES FL
34120-3315
US

IV. Provider business mailing address

490 16TH AVE NW
NAPLES FL
34120-3315
US

V. Phone/Fax

Practice location:
  • Phone: 512-981-8155
  • Fax:
Mailing address:
  • Phone: 512-981-8155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH16043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: