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NPI 1962369579

NPI 1962369579 : VIBRANT FAMILY CHIROPRACTIC PLLC : BRADENTON, FL

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General NPI Number Information
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    NPI Number           |    1962369579
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    Entity Type          |    Organization 
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    Legal Business Name  |    VIBRANT FAMILY CHIROPRACTIC PLLC 
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Dates
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    Enumeration Date     |    01/06/2026
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    Last Update Date     |    01/06/2026
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Provider Practice Location Address
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    Address Line         |    5454 LENA RD UNIT 107 
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    City                 |    BRADENTON
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    State                |    FL
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    Zip                  |    34211-9499
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    Country              |    US
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    Telephone            |    669-265-4191
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5454 LENA RD UNIT 107 
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    City                 |    BRADENTON
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    State                |    FL
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    Zip                  |    34211-9499
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CO-OWNER
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    Name                 |     ANDRE GABRIEL BEAULIEU 
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    Credential           |    DC
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    Telephone            |    669-265-4191
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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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