Healthcare Provider Details

I. General information

NPI: 1528300407
Provider Name (Legal Business Name): STELIOS ZOGRAFAKIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2154 DUCK SLOUGH BLVD SUITE 103
NEW PORT RICHEY FL
34655-5073
US

IV. Provider business mailing address

2154 DUCK SLOUGH BLVD SUITE 103
NEW PORT RICHEY FL
34655-5073
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-3333
  • Fax: 727-372-3331
Mailing address:
  • Phone: 727-372-3333
  • Fax: 727-372-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: