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General NPI Number Information
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NPI Number | 1336603083
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Entity Type | Individual
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Provider Name | MICHAEL SAMBURSKY DC
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Gender | Male
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 99 OLD KINGS RD S STE 4
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-4356
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Country | US
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Telephone | 386-693-4095
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Fax | 866-711-2736
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Provider Business Mailing Address
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Address Line | 99 OLD KINGS RD S STE 4
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-4356
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Country | US
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Telephone | 386-693-4095
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Fax | 866-711-2736
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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 | 12644
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License Number State | FL
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