Healthcare Provider Details

I. General information

NPI: 1265620595
Provider Name (Legal Business Name): UNIVERSITY CHIROPRACTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5245 UNIVERSITY PKWY UNIT 101
UNIVERSITY PARK FL
34201-3011
US

IV. Provider business mailing address

8233 COOPER CREEK BLVD
UNIVERSITY PARK FL
34201-2009
US

V. Phone/Fax

Practice location:
  • Phone: 941-360-2220
  • Fax: 941-360-2229
Mailing address:
  • Phone: 941-360-2220
  • Fax: 941-360-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7921
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES BRADY ARNSPERGER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 941-360-2220