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General NPI Number Information
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NPI Number | 1255003653
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY SUMMA JR. D.C
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Gender | Male
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 4282 W LINEBAUGH AVE
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City | TAMPA
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State | FL
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Zip | 33624-5241
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Country | US
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Telephone | 813-930-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 6250 PARK BLVD N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3237
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Country | US
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Telephone | 727-541-2520
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Fax |
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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 | 13712
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License Number State | FL
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