=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427844778
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIVOT CHIROPRACTIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2025
-----------------------------------------------------
Last Update Date | 04/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16349 MAGNOLIA BLUFF DR
-----------------------------------------------------
City | MONTVERDE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34756-3511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-205-8515
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13900 COUNTY ROAD 455 STE 107-304
-----------------------------------------------------
City | CLERMONT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34711-9052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-205-8515
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CHIROPRACTOR
-----------------------------------------------------
Name | BRITTANY LINDSEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-222-5617
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------