MEDICARE: MS. ASHLEY CANDICE SOOKLAL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH11951	FL

General Provider Information

NPI Number	:	1205382322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY CANDICE SOOKLAL D.C.

Provider Business Mailing Address
First Line	:	4104 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-5239
Country	:	US
Telephone Number	:	813-229-2225
Fax Number	:	813-221-2225

Provider Business Practice Location Address
First Line	:	1820 WELLNESS LN BLDG 4
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-5357
Country	:	US
Telephone Number	:	727-264-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2016
Last Update Date	:	02/02/2023

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