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General NPI Number Information
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NPI Number | 1700555281
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Entity Type | Organization
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Legal Business Name | CHIROCARE OF THE SUNCOAST, LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 10031 PINES BLVD STE 222
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6169
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Country | US
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Telephone | 941-402-8210
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Fax |
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Provider Business Mailing Address
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Address Line | 9015 TOWN CENTER PKWY SUITE # 135
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5308
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Country | US
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Telephone | 941-402-8210
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY O. ANDERSON
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Credential | D.C.
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Telephone | 941-402-8210
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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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