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General NPI Number Information
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NPI Number | 1346662244
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Entity Type | Organization
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Legal Business Name | COLON FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 10028 WATER WORKS LN
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City | RIVERVIEW
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State | FL
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Zip | 33578-5301
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Country | US
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Telephone | 813-677-9525
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Fax |
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Provider Business Mailing Address
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Address Line | 10028 WATER WORKS LN
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City | RIVERVIEW
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State | FL
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Zip | 33578-5301
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Country | US
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Telephone | 813-677-9525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHEYNID COLON
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Credential | D.C.
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Telephone | 787-565-7825
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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 | 10374
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License Number State | FL
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