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General NPI Number Information
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NPI Number | 1033488390
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Entity Type | Individual
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Provider Name | SAMUEL EVENSTEIN D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 6802 W HILLSBOROUGH AVE
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City | TAMPA
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State | FL
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Zip | 33634-5004
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Country | US
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Telephone | 813-890-8811
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Fax | 813-890-0088
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Provider Business Mailing Address
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Address Line | 6802 W HILLSBOROUGH AVE
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City | TAMPA
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State | FL
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Zip | 33634-5004
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Country | US
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Telephone | 813-890-8811
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Fax | 813-890-0088
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA-53141
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 11647
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License Number State | FL
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