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General NPI Number Information
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NPI Number | 1700358397
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Entity Type | Organization
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Legal Business Name | ROBERT J. INDELICATO DC
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 407 6TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1927
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Country | US
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Telephone | 941-746-2612
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Fax | 941-746-2789
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Provider Business Mailing Address
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Address Line | 407 6TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1927
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Country | US
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Telephone | 941-746-2612
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Fax | 941-746-2789
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT J INDELICATO
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Credential | DC
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Telephone | 941-746-2612
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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 |
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License Number State |
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