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General NPI Number Information
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NPI Number | 1194904870
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Entity Type | Organization
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Legal Business Name | PALM HARBOR SPINE CENTER INC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 5307 MAIN ST SUITE 104
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2536
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Country | US
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Telephone | 727-771-7200
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Fax | 727-781-0439
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Provider Business Mailing Address
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Address Line | 1440 LAWNWOOD CT
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3806
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Country | US
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Telephone | 727-479-8802
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Fax | 727-781-0439
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMAR G PATEL
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Credential | DC
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Telephone | 727-479-8802
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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 | CH9200
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License Number State | FL
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