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General NPI Number Information
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NPI Number | 1952633273
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Entity Type | Organization
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Legal Business Name | SW FLORIDA CHIROPRACTIC CENTER, INC
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 2014 SANTA BARBARA BLVD
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City | NAPLES
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State | FL
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Zip | 34116-5446
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Country | US
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Telephone | 239-348-7600
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Fax | 239-348-7601
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Provider Business Mailing Address
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Address Line | 2014 SANTA BARBARA BLVD
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City | NAPLES
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State | FL
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Zip | 34116-5446
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Country | US
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Telephone | 239-348-7600
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Fax | 239-348-7601
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | LAZ D RODRIGUEZ
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Credential | DC
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Telephone | 239-348-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH4496
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License Number State | FL
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