MEDICARE: ALL TAMPA BAY INJURY CENTER,INC

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	HCC7579	FL

General Provider Information

NPI Number	:	1427275940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL TAMPA BAY INJURY CENTER,INC

Provider Business Mailing Address
First Line	:	3115 W COLUMBUS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 W COLUMBUS DR
Second Line	:	SUITE 109
City	:	TAMPA
State	:	FL
Zip	:	33607-1865
Country	:	US
Telephone Number	:	813-871-1200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MS. EUGENIA MENENDEZ
Credential	:
Telephone Number	:	813-871-1200

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/22/2020

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