Healthcare Provider Details

I. General information

NPI: 1215840475
Provider Name (Legal Business Name): CIRCLE CHIROPRACTIC WELLEN PARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19740 W VILLAGES PKWY STE 102
VENICE FL
34293-2417
US

IV. Provider business mailing address

19740 W VILLAGES PKWY STE 102
VENICE FL
34293-2417
US

V. Phone/Fax

Practice location:
  • Phone: 941-234-9954
  • Fax:
Mailing address:
  • Phone: 941-234-9954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: BENJAMIN DUKE
Title or Position: OWNER
Credential:
Phone: 847-452-1371