Healthcare Provider Details

I. General information

NPI: 1326957614
Provider Name (Legal Business Name): SIMONA PRANAITIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10061 CLEARY BLVD
PLANTATION FL
33324-1063
US

IV. Provider business mailing address

640 NW 7TH AVE APT 1227
FORT LAUDERDALE FL
33311-8693
US

V. Phone/Fax

Practice location:
  • Phone: 954-982-6502
  • Fax:
Mailing address:
  • Phone: 815-735-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH16053
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: