Healthcare Provider Details

I. General information

NPI: 1962673863
Provider Name (Legal Business Name): LISA CAROL PARENTI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA CAROL WALKER DC

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 HWY A1A
SATELLITE BEACH FL
32937-2409
US

IV. Provider business mailing address

200 ELM AVE
SATELLITE BEACH FL
32937-3371
US

V. Phone/Fax

Practice location:
  • Phone: 321-765-5777
  • Fax: 321-234-9217
Mailing address:
  • Phone: 615-394-7711
  • Fax: 321-234-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberTN706
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: