Healthcare Provider Details

I. General information

NPI: 1497870208
Provider Name (Legal Business Name): TARPON TOTAL HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E TARPON AVE.
TARPON SPRINGS FL
34689-4322
US

IV. Provider business mailing address

400 E TARPON AVE
TARPON SPRINGS FL
34689-4322
US

V. Phone/Fax

Practice location:
  • Phone: 727-934-0844
  • Fax: 727-942-2072
Mailing address:
  • Phone: 727-934-0844
  • Fax: 727-942-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH6446
License Number StateFL

VIII. Authorized Official

Name: JOHN N HUY
Title or Position: CLINIC DIRECTOR
Credential: DCDACBN
Phone: 727-934-0844