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General NPI Number Information
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NPI Number | 1356509582
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC ASSOCIATES OF SOUTHWEST FLORIDA, INC.
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 8801 COLLEGE PKWY SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33919-4882
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Country | US
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Telephone | 239-437-2885
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Fax | 239-482-4757
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Provider Business Mailing Address
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Address Line | 8801 COLLEGE PKWY SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33919-4882
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Country | US
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Telephone | 239-437-2885
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Fax | 239-482-4757
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ESMAEEL SAMALIAZAD
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Credential | DC
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Telephone | 239-437-2885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH8642
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License Number State | FL
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