Healthcare Provider Details
I. General information
NPI: 1114730694
Provider Name (Legal Business Name): ALEXANDRA L ZAGORSKI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1707 W REYNOLDS ST STE 102
PLANT CITY FL
33563-4737
US
IV. Provider business mailing address
15435 TRINITY FALL WAY
BRADENTON FL
34212-3921
US
V. Phone/Fax
- Phone: 813-848-0022
- Fax:
- Phone: 941-840-3479
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH15358 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: