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General NPI Number Information
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NPI Number | 1164590410
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Entity Type | Individual
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Provider Name | DEBRA JEAN PAVLOVIC DC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 4122 EL CAMINO REAL E
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City | LAKELAND
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State | FL
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Zip | 33813-1021
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Country | US
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Telephone | 863-393-4169
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Fax | 863-937-6267
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Provider Business Mailing Address
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Address Line | 4122 EL CAMINO REAL E
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City | LAKELAND
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State | FL
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Zip | 33813-1021
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Country | US
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Telephone | 863-393-4169
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Fax | 863-937-6267
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR008047
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License Number State | GA
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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 | 2301009231
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3224
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9372
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License Number State | FL
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