MEDICARE: GONSTEAD CHIROPRACTIC CLINIC OF EAST FLORIDA LLC

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

General Provider Information

NPI Number	:	1275414468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GONSTEAD CHIROPRACTIC CLINIC OF EAST FLORIDA LLC

Provider Business Mailing Address
First Line	:	100 ALVA CIR APT 1107
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-7246
Country	:	US
Telephone Number	:	386-265-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1913 N CLYDE MORRIS BLVD STE 110
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5519
Country	:	US
Telephone Number	:	386-265-0000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. LINDY BAIRD
Credential	:	D.C.
Telephone Number	:	234-567-0567

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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