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General NPI Number Information
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NPI Number | 1790625515
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Entity Type | Organization
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Legal Business Name | TRSC LEGACY INC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 2980 ALLEGRA WAY
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City | LUTZ
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State | FL
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Zip | 33559-6998
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Country | US
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Telephone | 813-322-5330
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Fax | 813-582-7171
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Provider Business Mailing Address
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Address Line | 4019 W WATERS AVE STE E
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City | TAMPA
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State | FL
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Zip | 33614-2333
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Country | US
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Telephone | 813-322-5330
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Fax | 813-582-7171
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Authorized Official
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Title or Position | OWNER
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Name | LIANNY JIMENEZ URDANIVIA
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Credential |
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Telephone | 813-270-6205
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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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