MEDICARE: SUNCOAST CHIROPRACTIC 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	CH7982	FL

General Provider Information

NPI Number	:	1346306271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	687 TAMIAMI TRL
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33953-2903
Country	:	US
Telephone Number	:	941-743-9904
Fax Number	:	941-240-0078

Provider Business Practice Location Address
First Line	:	687 TAMIAMI TRL
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33953-2903
Country	:	US
Telephone Number	:	941-743-9904
Fax Number	:	941-743-9905

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG J BENTON
Credential	:	DC
Telephone Number	:	941-743-9904

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	01/14/2026

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