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General NPI Number Information
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NPI Number | 1760030332
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Entity Type | Individual
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Provider Name | TATIANA HABANOVA DC, DACNB
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 12300 S SHORE BLVD STE 218
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City | WELLINGTON
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State | FL
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Zip | 33414-6509
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Country | US
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Telephone | 561-444-7518
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Fax | 561-666-1311
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Provider Business Mailing Address
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Address Line | 2642 FAIRWAY COVE CT
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City | WELLINGTON
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State | FL
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Zip | 33414-7789
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Country | US
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Telephone | 561-204-5393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH8157
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License Number State | FL
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