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General NPI Number Information
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NPI Number | 1174291561
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Entity Type | Organization
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Legal Business Name | SPINAL SOLUTIONS FL LLC
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 2933 S FLORIDA AVE STE 7
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City | LAKELAND
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State | FL
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Zip | 33803-4037
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Country | US
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Telephone | 916-800-4947
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Fax | 407-738-4167
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Provider Business Mailing Address
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Address Line | 2933 S FLORIDA AVE STE 7
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City | LAKELAND
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State | FL
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Zip | 33803-4037
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Country | US
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Telephone | 916-800-4947
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Fax | 407-738-4167
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DEAN P HEGARTY
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Credential | DC,
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Telephone | 916-800-4947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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