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General NPI Number Information
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NPI Number | 1336394626
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Entity Type | Organization
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Legal Business Name | CORTEZ CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 15120 COUNTY LINE RD SUITE 104
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City | SPRING HILL
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State | FL
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Zip | 34610-6725
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Country | US
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Telephone | 727-233-3100
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Fax | 727-233-3168
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Provider Business Mailing Address
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Address Line | 15120 COUNTY LINE RD SUITE 104
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City | SPRING HILL
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State | FL
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Zip | 34610-6725
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Country | US
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Telephone | 727-233-3100
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Fax | 727-233-3168
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD SOSNOWSKI
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Credential | DC
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Telephone | 727-233-3100
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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 | CH 8662
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License Number State | ZZ
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